HE380 Managed Healthcare Exam 3 Answers (Ashworth College) - 2020

 HE380 Managed Healthcare Exam 3 Answers (Ashworth College) - 2020

 

 

 

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1. What type of physician contracting situation is a common type of HMO and is a legal entity that contracts with independent physicians?

2. Which of the following is NOT an example of a nonphysician professional?

3. What clause requires the provider to treat members no differently than the provider treats any other patients?

4. Which element of the provider contract describes the condition in which payment will be rendered?

5. Which type of system may comprise any of several provider organizational structures involving different types of providers?

6. Which of the following is NOT considered one of the areas in which primary care physicians specializes in?

7. What type of nonphysician clinician must practice under physician supervision and this refers to a physician being responsible for the clinical care provided by the specific professional?

8. What type of physician may be part of a medical group with exclusive rights or they may be employed directly by the hospital?

9. What element of the provider contract provides basic description of terms used on the contract?

10. What type of physician has a practice that is oriented toward care provided in the hospital?

11. What type of service is provided at the end of life?

12. What type of physician contraction situation is a common type, where the physician contracts directly with the health plan?

13. Which concept is a federal database created by combining two other federal databases, the National Practitioner Data Bank (NPDB) and the Healthcare Integrity and Protection Data Bank (HIPDB)?

14. What party or individual is responsible for credentialing of physicians?

15. Complete the following statement: Access standards are considered:

16. Which concept is the defined geographic area in which the plan provides access to primary and specialty care, hospital care, emergency care, and certain other health services?

17. What number is 10-digit number that is unique and never ending and is one of the mandates included in HIPAA?

18. This concept is considered a legally binding document that defines the terms, conditions, and obligations to which both parties have agreed.

19. Which of the following is a reason for conducting an audit of medical records?

20. Which of the following is NOT considered a physician other than MDs or Dos?