AHM-530 Exam Dumps : Network Management

Provide a directory of contracted providers

Help providers and their staffs develop methods of improving the operation of their practices

Provide feedback to providers regarding their performance

Reinforce and document contractual provisions

Made for services rendered to specific patients

Made with matching state and federal funds

Included in the Medicaid capitation payment made to patients’ health plans

Defined as cost-based reimbursement (CBR) equal to 100% of Portway’s reasonable costs of providing services to Medicaid recipients

To keep Medicaid enrollment costs as low as possible, states typically prohibit the use of third-party entities known as enrollment brokers to handle the recruitment and enrollment of Medicaid recipients in health plan plans

Primary care case managers (PCCMs) are individuals who contract with a state's Medicaid agency to provide primary care services mainly to urban areas.

Typically, Medicaid beneficiaries must be given a choice between at least two health plan entities.

Medicaid health plan entities are responsible for providing primary coverage for all dually-eligible beneficiaries.