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AHM-530 Exam Dumps : Network Management

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Network Management Questions and Answers

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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

Health plans are required to follow several regulations and guidelines regarding the access and adequacy of their provider networks. The Federal Employee Health Benefits Program (FEHBP) regulations, for example, require that health plans

Options:

A.

Allow members direct access to OB/GYN services

B.

Allow members direct access to prescription drug services

C.

Provide access to Title X family-planning clinics

D.

Provide average office waiting times of no more than 30 minutes for appointments with plan providers

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

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