Which document outlines the agreed payment terms and conditions between providers and payers?

Prepare for your Health Insurance Billing Exam. Utilize flashcards and multiple choice questions, each with explanations. Boost your readiness!

A service contract is the document that outlines the agreed payment terms and conditions between healthcare providers and payers. This contract typically details the reimbursement rates, the responsibilities of each party, and any specific terms related to billing and payment processes. It serves as a formal agreement that governs the financial relationship and ensures clarity on what services will be reimbursed, at what rates, and under what conditions.

In contrast, a pre-authorization form is used to obtain approval from a payer before certain medical services are rendered, ensuring they will be covered. A billing statement is a document that communicates the charges incurred by a patient for services rendered, but it does not establish payment terms. An insurance policy outlines the coverage provided by the insurer, including benefits and exclusions, but it does not specifically define the terms of payment between providers and payers.

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