AHM-530 Exam Dumps : Network Management

The BBA requires Medicare+Choice organizations to be licensed as non-risk-bearing entities under federal law.

The Centers for Medicaid and Medicare Services (CMS) is responsible for implementing the BBA.

Both A and B

A only

B only

Neither A nor B

20%, and therefore this arrangement puts her at substantial financial risk

20%, and therefore this arrangement does not put her at substantial financial risk

25%, and therefore this arrangement puts her at substantial financial risk

25%, and therefore this arrangement does not put her at substantial financial risk

A discounted fee-for-service (DFFS) system is usually easier for a health plan to administer than is a fee schedule system.

A case rate payment system offers providers an incentive to take an active role in managing cost and utilization.

One reason that health plans use a relative value scale (RVS) payment system is that RVS values for cognitive services have traditionally been higher than the values for procedural services.

One reason that health plans use a resource-based relative value scale (RBRVS) is that this system includes weighted unit values for all types of procedures.