AHM-540 Exam Dumps : Medical Management

To see that utilization guidelines are consistently applied, UR programs rely on authorization systems. Determine whether the following statement about authorization systems is true or false:

Only physicians can make nonauthorization decisions based on medical necessity.

In most health plans, the formulary system is developed and managed by a P&T committee. The P&T committee is responsible for

In order to be effective, a clinical pathway must improve quality and decrease costs.