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Healthcare Management: An Introduction Questions 171–175 (page: 36)

Updated On: 10-Feb-2026

The application of health plan principles to workers' compensation insurance programs has presented some unique challenges because of the differences between health plan for traditional group healthcare and workers' compensation. One key difference is that

  1. limits coverage to eligible employees and excludes part-time employees
  2. specifies an annual lifetime benefit maximum on dollar coverage for medical costs
  3. provides benefits regardless of the cause of an injury or illness
  4. provides benefits for both healthcare costs and lost wages

Answer(s): D



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

  1. Credentialing
  2. Accreditation
  3. A sentinel event
  4. A screening program

Answer(s): A



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

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

Answer(s): D



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

  1. A holding company of the Fordham Group.
  2. A sister corporation of the Fordham Group.
  3. A subsidiary of the Fordham Group.
  4. All of the above.

Answer(s): C



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

  1. provider profiling
  2. benchmarking
  3. peer review
  4. quality assessment

Answer(s): B



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