AHM-530 Exam Dumps : Network Management

Medicare and private indemnity insurance, and Medicare provides primary coverage

Medicare and Medicaid, and Medicare provides primary coverage

Medicaid and private indemnity insurance, and Medicaid provides primary coverage

Medicare and Medicaid, and Medicaid provides primary coverage

Provides the lowest level of cost for the health plan

Most closely represents what pharmacies are actually charged for prescription drugs

Offers the best control over multiple-source pharmaceutical products

Is the least expensive pricing system for the health plan to implement

A discounted fee-for-service (DFFS) system is usually easier for a health plan to administer than is a fee schedule system.

A case rate payment system offers providers an incentive to take an active role in managing cost and utilization.

One reason that health plans use a relative value scale (RVS) payment system is that RVS values for cognitive services have traditionally been higher than the values for procedural services.

One reason that health plans use a resource-based relative value scale (RBRVS) is that this system includes weighted unit values for all types of procedures.