AHM-540 Exam Dumps : Medical Management

maintaining clinical practices

delivering performance feedback to providers

participating in utilization management (UM) activities

educating other MCO staff about new clinical developments or provider innovations that might impact clinical practice management

Health plans typically use provider profiles to improve the quality of care associated with the use of prescription drugs.

Provider profiles identify prescribing patterns that fall outside normal ranges.

Health plans can motivate providers to change their prescribing patterns by sharing profile information with plan members and the general public.

Provider profiles are effective in modifying individual prescribing patterns, but they have little effect on group prescribing patterns.

evaluating and selecting drugs for inclusion in the formulary

overseeing the manufacture, distribution, and marketing of prescription drugs

certifying the medical necessity of expensive, potentially toxic, or nonformulary drugs

all of the above