[Expert Solution]: C

C. Established patient Dorothy Scoval telephones 1 week after her initial encounter complaining of chest pain and shortness of breath. She asks if she can schedule an appointment with an Envision cardiologist. The scheduling receptionist refers the call to you, the health insurance professional. How should this request be handled? D. The medical facility in which you work as a health insurance professional is part of Envision, a staff model HMO. The healthcare providers are employees of the HMO and see patients on a “capitated” (per-patient) basis. How does this payment structure affect claims submission for the plan’s enrollees?