What is a stop-loss provision?
A. A provision where a provider agrees to only bill a patient up to a maximum amount.
B. A provision that provides protection to a provider for medical expenses that exceed certain levels.
C. A provision where a provider agrees to only bill an insurer up to a maximum amount.
D. A provision where a provider agrees to accept patients that will not exceed a certain level of expenses.

A stop-loss provision is a healthcare agreement that limits the amount a provider can bill an insurer for medical expenses. The correct option is that it allows providers to bill insurers only up to a maximum amount. This protective measure benefits both patients and insurers by capping expenses. ;

Answered by GinnyAnswer | 2025-07-07

A stop-loss provision is a healthcare agreement that limits how much a provider can bill an insurer, ensuring financial protection for both parties. The correct option is C: A provision where a provider agrees to only bill an insurer up to a maximum amount. This helps to cap expenses and manage the risks associated with high medical costs.
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Answered by Anonymous | 2025-07-11