A Method Used by a Health Plan to Measure the Amount

question 28

Multiple Choice

A method used by a health plan to measure the amount and appropriateness of health services used by its members is called a(n)

• A) coinsurance review.
• B) capitation review.
• C) accountable care review.
• D) formulary review
• E) utilization review.

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Definitions:

Modify

Describes the act of making alterations or adjustments to something, often to improve it or to make it more suitable for a particular purpose.

Temperaments

The innate aspects of an individual's personality, such as introversion or extroversion, that are often evident from infancy and are relatively stable over time.

Chess and Thomas

Researchers known for their categorization of children's temperaments into three basic types: easy, difficult, and slow-to-warm-up.

Post-Traumatic Stress Disorder

A mental health condition triggered by experiencing or witnessing a terrifying event, characterized by flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event.