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What is the term that means evaluating for a healthcare service the appropriateness of its setting and its level of service?Utilization Management (UM)
Wikipedia Definition: “…the evaluation of the appropriateness and medical need of health care services and procedures and facilities according to evidence-based criteria or guidelines, and under the provisions of an applicable health benefits plan.
What is the term for an MCO that serves Medicare beneficiaries?What is the term for an MCO that serves Medicare beneficiaries? Medicare Advantage.
For what type of care should the physician practice manager except to work with a case manager?Rev Cycle Final. What is the intent of Managed health care?The purpose of managed care is to enhance the quality of healthcare for all patient populations. Managed care revolves around the collaboration of health insurance plans and healthcare providers. Managed Care includes healthcare plans that are used to manage cost, utilization, and quality.
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