QUESTION: 173

The Ark Health Plan, is currently recruiting providers in preparation for its expansion into a new service area. A recruiter for Ark has been meeting with Dr. Nan Shea, a pediatrician who practices in Ark's new service area, in order to convince her to be

Has ever participated in any quality improvement activities.
Is a participating provider in a health plan that will compete with Ark in its new service area.
Meets the requirements of the Ethics in Patient Referrals Act.
Has had a medical malpractice claim filed or other disciplinary actions taken against her.

Answer(s): D

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QUESTION: 174

The Azure Group is a for-profit health plan that operates in the United States. The Fordham Group owns all of Azure's stock. The Fordham Group's sole business is the ownership of controlling interests in the shares of other companies. This information ind

A holding company of the Fordham Group.
A sister corporation of the Fordham Group.
A subsidiary of the Fordham Group.
All of the above.

Answer(s): C

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QUESTION: 175

The Blaine Healthcare Corporation seeks to manage its quality by first identifying the best practices and best outcomes for a given procedure. Blaine can then determine areas in which it can emulate the best practices in order to equal or surpass the best

provider profiling
benchmarking
peer review
quality assessment

Answer(s): B

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QUESTION: 176

The Citywide Health Group is a large provider-based health plan that includes physician groups, hospitals, and other facilities. In order to oversee and manage the operation of the organization, Citywide has established an enterprise scheduling system. The

provide information to Citywide's management regarding provider licensure, certification, and malpractice history
detect instances of overutilization, underutilization, or inappropriate utilization of medical resources
allow Citywide's different components to function as a single organization in arranging access to facilities and resources
facilitate the processing of requests for authorization of payment of benefits

Answer(s): C

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QUESTION: 173

QUESTION: 174

QUESTION: 175

QUESTION: 176