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  2. Topic
    Medicine
  3. Study Set
    Comprehensive Health Insurance
  4. Exam
    Exam 15: Explanation of Benefits and Payment Adjudication
  5. Question
    A Percentage of a Provider's Payment That Is NOT Paid
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A Percentage of a Provider's Payment That Is NOT Paid

Question 3

Question 3

Multiple Choice

A percentage of a provider's payment that is NOT paid during a contract year but is kept by the health plan to offset additional costs incurred for referrals, hospital admissions, or other covered services is called a:


A) disincentive.
B) per-member-per-month (PMPM) fee.
C) withdrawal.
D) withhold.

Correct Answer:

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