AHIP AHM-250 Exam With Confidence Using Practice Dumps

an evaluation of the medical necessity, efficiency, and/or appropriateness of healthcare services and treatment plans for a given patient

a series of strategies designed to reduce plan members' needs to utilize healthcare services by encouraging preventive care, wellness, member self-care, and appropriate use of healthcare services

a technique that prevents a provider who is being reimbursed under a fee schedule arrangement from billing a plan member for any fees that exceed the maximum fee reimbursed by the plan

a system of identifying plan members with special healthcare needs, developing a healthcare strategy to meet those needs, and coordinating and monitoring the care

Within Ultra's system, Ms. Chan received primary care from both Dr. Craig and Dr. Lee

Ultra's system allows its members open access to all of Ultra's participating providers.

Within Ultra's system, Dr. Craig serves as a coordinator of care or gatekeeper for the medical services that Ms. Chan receives.

Ultra's network of providers includes Dr. Craig and Dr. Lee but not Arrow Hospital

After a period of relative stability, annual growth in private health spending per capita began to increase rapidly in 2002.

During the height of the recent cost upswing, insurance premiums were increasing by more than 13% annually.

Increased utilization was the largest factor contributing to the rise in premiums, accounting for 43% of the increase.

Employer payers began seeking ways to control spiraling utilization rates and provide lower cost health coverage options.