Certified Revenue Cycle Representative (CRCR) Practice Exam

Discounted fee-for-service agreements typically require what from healthcare providers?

1. The price of services to be fixed

2. Agreement to discount fees for certain packages

3. No charge to patients

4. Insurance approval before services are rendered

The correct answer is: Agreement to discount fees for certain packages

Discounted fee-for-service agreements generally involve healthcare providers agreeing to discount fees for a predefined set of services, which may be presented in specific packages. This arrangement allows healthcare providers to attract patients and payers by offering reduced rates while still maintaining the flexibility of fee-for-service billing. In such agreements, the criteria for the discounts; such as the types of services included or the percentage by which fees are reduced, are usually negotiated upfront. This helps to ensure that both the provider and the payer—typically an insurance company or a managed care organization—have a clear understanding of the financial terms associated with care delivery. The other options do not accurately describe the primary requirement of discounted fee-for-service agreements. Fixing the price of services is less flexible than the nature of these agreements intends and does not reflect discounts. Offering no charge to patients is not feasible in a healthcare reimbursement model. Insurance approval, while important in many contexts, is not a standard requirement of such discount agreements.