AHIP Network Management AHM-530 Question # 98 Topic 4 Discussion

AHIP Network Management AHM-530 Question # 98 Topic 4 Discussion

AHM-530 Exam Topic 4 Question 98 Discussion:
Question #: 98
Topic #: 4

The Elizabethan Health Plan uses a direct referral program, which means that


A.

PCPs in Elizabethan’s network can make most referrals without obtaining prior authorization from Elizabethan


B.

PCPs in Elizabethan’s network must always refer plan members to other specialists within the network


C.

Elizabethan’s plan members can bypass the PCP and obtain medical services from a specialist without a referral


D.

Elizabethan’s plan members must obtain referrals directly from Elizabethan


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