AHM-250 Exam Dumps : Healthcare Management: An Introduction

a manual rating contract

a funding vehicle contract

an administrative services only (ASO) contract

a pooling contract

Assume full financial risk for arranging medical services for their members.

Require plan members to obtain a referral before getting medical services from specialists.

Use a capitation arrangement, instead of a fee schedule, to reimburse physicians.

Offer some coverage, although at a higher cost, for plan members who choose to use the services of non-network providers.

Accreditation is typically performed by a panel of physicians and administrators employed by the health plan under evaluation.

All accrediting organizations use the same standards of accreditation.

Results of accreditation evaluations are provided only to state regulatory agencies and are not made available to the general public.

Accreditation demonstrates to an health plan's external customers that the plan meets established standards for quality care.