Order Now

Herzing University Online Managed Care Contracts

Herzing University Online Managed Care Contracts

Herzing University Online Managed Care Contracts

Unit 5 Assignment – MCO Contract

Submit Assignment

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.

ORDER NOW FOR CUSTOMIZED SOLUTION PAPERS

 

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 parameters
    • Administrative cost criteria
    • Provider cost and responsibility
    • Volume
    • Risk assumption criteria
    • Claims payments and eligibility determination
    • Eligibility determination and prior authorization
    • Dispute resolution
    • Contract Termination
  • Provide 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.

Rubric

Unit 5 Assignment – MCO Contract

Unit 5 Assignment – MCO Contract
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeContent
35.0 ptsLevel 5

Demonstrates the ability to construct a clear and insightful problem statement/thesis statement/topic statement with evidence of all relevant contextual factors.

 31.5 ptsLevel 4

Demonstrates the ability to construct a problem statement, thesis statement/topic statement with evidence of most relevant contextual factors, and problem statement is adequately detailed.

 28.0 ptsLevel 3

Begins to demonstrate the ability to construct a problem statement/thesis statement/topic statement with evidence of most relevant contextual factors, but problem statement is superficial.

 24.5 ptsLevel 2

Demonstrates a limited ability in identifying a problem statement/thesis statement/topic statement or related contextual factors.

 21.0 ptsLevel 1

Demonstrates the ability to explain contextual factors but does not provide a defined statement.

 0.0 ptsLevel 0

There is no evidence of a defined statement.
35.0 pts
This criterion is linked to a Learning OutcomeAnalysisPRICE-P
35.0 ptsLevel 5

Organizes and compares evidence to reveal insightful patterns, differences, or similarities related to focus.

 31.5 ptsLevel 4

Organizes and interprets evidence to reveal patterns, differences, or similarities related to focus.

 28.0 ptsLevel 3

Organizes and describes evidence according to patterns, differences, or similarities related to focus.

 24.5 ptsLevel 2

Organizes evidence, but the organization is not effective in revealing patterns, differences, or similarities.

 21.0 ptsLevel 1

Describes evidence, but it is not organized and/or is unrelated to focus.

 0.0 ptsLevel 0

Lists evidence, but it is not organized and/or is unrelated to focus.
35.0 pts
This criterion is linked to a Learning OutcomeWriting
5.0 ptsLevel 5

The paper exhibits an excellent command of written English language conventions. The paper has no errors in mechanics, grammar, or spelling.

 4.5 ptsLevel 4

The paper exhibits a good command of written English language conventions. The paper has no errors in mechanics or spelling with minor grammatical errors that impair the flow of communication.

 4.0 ptsLevel 3

The paper exhibits a basic command of written English language conventions. The paper has minor errors in mechanics, grammar, or spelling that impact the flow of communication.

 3.5 ptsLevel 2

The paper exhibits a limited command of written English language conventions. The paper has frequent errors in mechanics, grammar, or spelling that impede the flow of communication.

 3.0 ptsLevel 1

The paper exhibits little command of written English language conventions. The paper has errors in mechanics, grammar, or spelling that cause the reader to stop and reread parts of the writing to discern meaning.

 0.0 ptsLevel 0

The paper does not demonstrate command of written English language conventions. The paper has multiple errors in mechanics, grammar, or spelling that cause the reader difficulty in discerning the meaning.
5.0 pts
This criterion is linked to a Learning OutcomeAPAPRICE-I
5.0 ptsLevel 5

The required APA elements are all included with correct formatting, including in-text citations and references.

 4.5 ptsLevel 4

The required APA elements are all included with minor formatting errors, including in-text citations and references.

 4.0 ptsLevel 3

The required APA elements are all included with multiple formatting errors, including in-text citations and references.

 3.5 ptsLevel 2

The required APA elements are not all included and/or there are major formatting errors, including in-text citations and references.

 3.0 ptsLevel 1

Several APA elements are missing. The errors in formatting demonstrate a limited understanding of APA guidelines, in-text-citations, and references.

 0.0 ptsLevel 0

There is little to no evidence of APA formatting and/or there are no in-text citations and/or references.
5.0 pts
Total Points: 80.0
× How can I help you?