The Following Statements Are About the Specialist Component of a Provider

question 38

Multiple Choice

The following statements are about the specialist component of a provider panel. Select the answer choice containing the correct statement.

• A) Ideally, a health plan should have every specialist category represented on its provider panel with appropriate geographic distribution.
• B) Most specialist contracts do not ensure the provider's adherence to UM policies set up by the health plan.
• C) No-balance-billing clauses are not desirable in health plan contracts with specialists.
• D) In geographic regions where there is a shortage of PCPs, a health plan is not permitted to contract with specialists to perform primary care services, even for patients with chronic conditions.

---

Definitions:

Fixed Factory Overhead Volume Variance

The difference between the budgeted amount for fixed factory overhead and the amount applied to production, based on standard cost.

Direct Materials Quantity Variance

A financial measure that shows the difference between the actual quantity of materials used and the standard quantity expected for production.

Standard Price

The predetermined cost that a company expects to pay for inventory or inputs, used for budgeting and variance analysis.

Variable Factory Overhead

Costs that fluctuate with production volume, such as utilities and materials used in the manufacturing process.