Health Plans Typically Conduct Two Types of Reviews of a Provider's

question 67

Multiple Choice

Health plans typically conduct two types of reviews of a provider's medical records: an evaluation of the provider's medical record keeping (MRK) practices and a medical record review (MRR) . One true statement about these types of reviews is that:

• A) An MRK covers the content of specific patient records of a provider.
• B) The NCQA requires an examination of MRK with all of a health plan's office evaluations.
• C) An MRR includes a review of the policies, procedures, and documentation standards the provider follows to create and maintain medical records.
• D) The NCQA requires MRR for both credentialing and recredentialing of providers in a health plan's network.

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