AHM-250 VCE Exam Download

higher costs for health plans, healthcare purchasers, and healthcare consumers

improved provider contracting position with health plans

an increase in providers' autonomy and control over their own work environment

all of the above

Greentree is prevented by law from offering a contract to Dr. Cortelyou until the credentialing process is complete

any contract signed by Dr. Cortelyou should include a clause requiring the successful completion of the credentialing process within a defined time frame in order for the contract to be effective

Greentree must offer a standard contract to Dr. Cortelyou, without regard to the outcome of the credentialing process

Greentree will abandon the credentialing process now that Dr. Cortelyou has agreed to participate in Greentree's network

an evaluation of the medical necessity, efficiency, and/or appropriateness of healthcare services and treatment plans for a given patient

a series of strategies designed to reduce plan members' needs to utilize healthcare services by encouraging preventive care, wellness, member self-care, and appropriate use of healthcare services

a technique that prevents a provider who is being reimbursed under a fee schedule arrangement from billing a plan member for any fees that exceed the maximum fee reimbursed by the plan

a system of identifying plan members with special healthcare needs, developing a healthcare strategy to meet those needs, and coordinating and monitoring the care

Closed-access HMO

Closed-panel HMO

Open-access HMO

Open-panel HMO