AHM-530 Exam Dumps : Network Management

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

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

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

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

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

Made for services rendered to specific patients

Made with matching state and federal funds

Included in the Medicaid capitation payment made to patients’ health plans

Defined as cost-based reimbursement (CBR) equal to 100% of Portway’s reasonable costs of providing services to Medicaid recipients