<u>Elements of managed care contracts:</u>
Participating provider- A licensed healthcare provider who has entered into an agreement to provide covered services to covered individuals.
Benefit plan- Contract issued by a payer under which a covered person may be entitled to covered services.
Covered services- Healthcare services provided to covered persons under the terms of the benefit plan.
Copayment- The amount that a covered person is required to pay at the time of the service.
Coordination of benefits- The determination of which health plan will pay for covered services as primary on secondary payer.
