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Katrina Lopez is a claims analyst for a health plan that provides a higher level of benefits for services received in-network than for services received out-of-network. Ms. Lopez reviewed a health claim for answers to the following questions:
Question A
The Ark Health Plan, is currently recruiting providers in preparation for its expansion into a new service area. A recruiter for Ark has been meeting with Dr. Nan Shea, a pediatrician who practices in Ark's new service area, in order to convince her to be
The statements below describe technology used by two health plans to respond to incoming telephone calls:
-The Manor Health Plan uses an automated system that answers telephone calls with recorded or synthesized speech and prompts the caller to respond t
The following statements are about the make-up and function of an HMO's board of directors.
Select the answer choice that contains the correct statement.
Dr. Julia Phram is a cardiologist under contract to Holcomb HMO, Inc., a typical closed-panel plan. The following statements are about this situation. Select the answer choice containing the correct statement.
