Essay 5: MCO Contract
Essay 5: MCO Contract
Managed care contracts allow the provider and managed care organization to create a relationship that defines the rights and obligations of each party. Examples of managed care organizations include HMO, PPO, and POS.Instructions
Select one managed care organization and create a two-page hospital inpatient managed care contract. The contract can be written from the perspective of the MCO.Your contract should address information from a minimum of 5 of the following areas:Reimbursement levels and parametersAdministrative cost criteriaProvider cost and responsibilityVolumeRisk assumption criteriaClaims payments and eligibility determinationEligibility determination and prior authorizationDispute resolutionContract TerminationProvide a detailed explanation stating how each of your selected criteria should be written to protect the MCO.Submit both parts of this assessment in the same document.Please be sure to validate your opinions and ideas with citations and references in APA format.
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
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