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AHM-530 Exam Dumps : Network Management

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Network Management Questions and Answers

Question 1

Before or during the orientation process, health plans generally provide new network providers with a provider manual. One of the primary purposes of the provider manual is to

Options:

A.

Provide a directory of contracted providers

B.

Help providers and their staffs develop methods of improving the operation of their practices

C.

Provide feedback to providers regarding their performance

D.

Reinforce and document contractual provisions

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Question 2

An health plan’s contract negotiation team consists of several skilled individuals from different areas. At least one of the members is responsible for evaluating the wording of specific clauses to ensure that the health plan’s rights are protected, as well as to ensure that the contract is in compliance with state and federal regulation. By profession, this member of the contract negotiation team is typically

Options:

A.

Amedical director

B.

An attorney

C.

Afinancial manager

D.

Aclaims manager

Question 3

The actual number of providers included in a provider network may be based on staffing ratios. Staffing ratios relate the number of

Options:

A.

Potential providers in a plan’s network to the number of individuals in the area to be served by the plan

B.

Providers in a plan’s network to the number of enrollees in the plan

C.

Providers outside a plan’s network to the number of providers in the plan’s network

D.

Support staff in a plan’s network to the number of medical practitioners in the plan’s network