AHM-530 Exam Dumps : Network Management

average cost of services delivered to all patients living in a specified geographic region

actuarial value of the deductible and coinsurance amounts for basic Medicare-covered benefits

fee-for-service amount that the Centers for Medicaid and Medicare Services (CMS) would pay for a Medicare beneficiary, adjusted for age, sex, and institutional status

average fixed monthly fee paid by all Medicare enrollees in a specified geographic region

the fact that unified benefits improve the quality of patient care and the value of pharmacy services to Pine's plan members

the fact that control over the formulary and network contracting can give Pine control over patient access to prescription drugs and to pharmacies

the fact that managing pharmacy benefits in-house gives Pine a better chance to meet customer needs by integrating pharmacy services into the plan's total benefits package

all of the above

Require Dr. Barlow and Amity to use arbitration to resolve any disputes regarding the contract

Specify that the contract is to be governed by the laws of the state in which Amity has its headquarters

Require Dr. Barlow to charge Amity her lowest rate for a medical service she has provided to an Amity plan member, even if the rate is lower than the price negotiated in the contract

State that the contract creates an employment or agency relationship, rather than an independent contractor relationship, between Dr. Barlow and Amity