AHM-530 Exam Dumps : Network Management

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.

Allow members direct access to OB/GYN services

Allow members direct access to prescription drug services

Provide access to Title X family-planning clinics

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

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