Most Health Plan Contracts Provide an Outline of the Criteria

question 109

Multiple Choice

Most health plan contracts provide an outline of the criteria that a healthcare service must meet in order to be considered "medically necessary." Typically, in order for a healthcare service to be considered medically necessary, the service provided by a physician or other healthcare provider to identify and treat a member's illness or injury must be

• A) Consistent with the symptoms of diagnosis
• B) Furnished in the least intensive type of medical care setting required by the member's condition
• C) In compliance with the standards of good medical practice
• D) All of the above

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Definitions:

Stockholders' Equity

The residual interest in the assets of a corporation that remains after deducting its liabilities, often referred to as shareholders' equity or owners' equity.

Public Markets

Marketplaces that are open to the public where securities, commodities, and other financial instruments are traded.

Market Value

The contemporary pricing for transactions involving assets or services on the market.

Stock Split

A corporate action that increases the number of a company's outstanding shares by issuing more shares to current shareholders, thus reducing the price of each share.