Managed Care Plan in Medical Billing
A managed care plan is a type of health insurance that contracts with healthcare providers to deliver care at reduced costs, often requiring patients to use a network of providers.
Managed Care Plan in Medical Billing Explained
In medical billing, managed care plans, such as HMOs or PPOs, have set rules for reimbursement, including the use of in-network providers and pre-authorization for certain services. Providers must follow these guidelines to ensure claims are paid.
For example, a patient with a managed care plan must visit an in-network provider to avoid higher out-of-pocket costs.
Explore acronyms and abbreviations in Medical billing glossary.
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