AHIP Medical Management AHM-540 Question # 49 Topic 1 Discussion
AHM-540 Exam Topic 1 Question 49 Discussion:
Question #: 49
Topic #: 1
The following statements are about the characteristics of a utilization review (UR) program. Three of the statements are true and one is false. Select the answer choice containing the FALSE statement.
A.
A primary goal of UR is to address practice variations through the application of uniform standards and guidelines.
B.
UR evaluates whether the services recommended by a member’s provider are covered under the benefit plan.
C.
UR recommends the procedures that providers should perform for plan members.
D.
A health plan’s UR program is usually subject to review and approval by the state insurance and/or health departments.
Chosen Answer:
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