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Exam contains 198 questions

Page 6 of 33
Question 31 🔥

In contracting with providers, a health plan can use a closed panel or open panel approach. One statement that can correctly be made about an open panel health plan is that the participating providers.

Which database solution meets these requirements?
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Question 32 🔥

In open panel contracting, there are several types of delivery systems. One such delivery system is the faculty practice plan (FPP). One likely result that a health plan will experience by contracting with an FPP is that the health plan will:

Which database solution meets these requirements?
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Question 33 🔥

The following statement(s) can correctly be made about hospitalists:1. The hospitalist's main function is to coordinate diagnostic and treatment activities to ensure that the patient receives appropriate care while in the hospital.2. The hospitalist's role clearly supports the health plan concept of disease management.

Which database solution meets these requirements?
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Question 34 🔥

Salvatore Arris is a member of the Crescent Health Plan, which provides its members with a full range of medical services through its provider network. After suffering from debilitating headaches for several days, Mr. Arris made an appointment to see Neal Prater, a physician's assistant in the Crescent network who provides primary care under the supervision of physician Dr. Anne Hunt. Mr. Prater referred Mr. Arris to Dr. Ginger Chen, an ophthalmologist, who determined that Mr. Arris' symptoms were indicative of migraine headaches. Dr. Chen prescribed medicine for Mr. Arris, and Mr. Arris had the prescription filled at a pharmacy with which Crescent has contracted. The pharmacist, Steven Tucker, advised Mr. Arris to take the medicine with food or milk.In this situation, the person who functioned as an ancillary service provider is:

Which database solution meets these requirements?
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Question 35 🔥

Open panel health plans can contract with individual providers or with various provider groups when developing their networks. The following statements are about factors that an open panel health plan might consider in contracting with different types of provider organizations. Select the answer choice that contains the correct statement.

Which database solution meets these requirements?
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Question 36 🔥

By definition, a measure of the extent to which a health plan member can obtain necessary medical services in a timely manner is known as:

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