AHM-530 Exam Dumps : Network Management

has a legal right to access a prospective provider’s confidential medical records at any time

must limit any evaluations of a prospective provider’s office to an assessment of quantitative factors, such as the number of double-booked appointments a physicianaccepts at the end of each day

is prohibited by law from conducting primary verification of such data as a prospective provider’s scope of medical malpractice insurance coverage and federal tax identification number

must complete the credentialing process before a provider signs the network contract or must include in the signed document a provision that the final contract is contingent upon the completion of the credentialing process

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.

medical advisory committee

credentialing committee

utilization management committee

quality management committee