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Network Management

Last Update Nov 21, 2024
Total Questions : 202

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Network Management Questions and Answers

Questions 1

Health plans use a variety of sources to find candidates to recruit for their provider networks. In general, two of the most effective methods of finding candidates are through

Options:

A.

Word of mouth and on-site training programs

B.

Word of mouth and direct mail

C.

Advertisements in local newspapers and on-site training programs

D.

Advertisements in local newspapers and direct mail

Questions 2

The following statements are about factors that health plans should consider as they develop provider networks in rural and urban markets. Three of the statements are true, and one of the statements is false. Select the answer choice that contains the FALSE statement.

Options:

A.

Compared to providers in urban areas, providers in rural areas are less likely to offer discounts to health plans in exchange for directed patient volume.

B.

In urban areas, limiting the number of specialists on a panel usually affects the network’s market appeal more than does limiting the number of primary care physicians.

C.

The greatest opportunity to create competition in rural areas is among the specialty providers in other nearby communities.

D.

Typically, hospital contracting is easier in urban areas than in rural areas.

Questions 3

If a third party is responsible for injuries to a plan member of the Hope Health Plan, then Hope has a contractual right to file a claim for the resulting healthcare costs against the third party. This contractual right to recovery from the third party is known as

Options:

A.

Subrogation

B.

Partial capitation

C.

Coordination of benefits

D.

Aremedy provision

Next Question
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