AHIP Medical Management AHM-540 Question # 49 Topic 1 Discussion

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.


Get Premium AHM-540 Questions

Contribute your Thoughts:


Chosen Answer:
This is a voting comment (?). It is better to Upvote an existing comment if you don't have anything to add.