A Common Process Used by Many Healthcare Payers to Monitor

question 13

Multiple Choice

A common process used by many healthcare payers to monitor and control healthcare costs by prior evaluation and necessity of most hospitalizations and certain medical services.

• A) Appeal
• B) Grievance
• C) Equalization
• D) Preauthorization

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Definitions:

Repetitive

Characterized by or involving repetition, especially in actions, events, or processes, leading to a lack of variety.

Motivational Factors

Elements or conditions that drive individuals to put forth effort towards achieving goals and performing tasks.

Job Enrichment

A method of motivating employees by adding variety, autonomy, and increased responsibility to their roles to enhance job satisfaction and performance.

Redesigning

The process of revising or completely changing the design of a product, service, or system to improve functionality or appearance.