Prior to scheduling elective surgery, managed care plans often require a __________ during which another physician is asked to evaluate the necessity of surgery and recommend the most economical, appropriate facility in which to perform the surgery.
A) preauthorization
B) prospective review
C) retrospective review
D) second surgical opinion
Correct Answer:
Verified
Q16: The National Committee for Quality Assurance (NCQA)
Q17: With managed care's capitation financing method, if
Q18: Which is a review that grants prior
Q19: The Health Maintenance Organization (HMO) Assistance Act
Q20: Reviewing the appropriateness and necessity of care
Q22: Which involves the development of patient care
Q23: Which is associated with contracted health care
Q24: An integrated delivery system (IDS) is an
Q25: Which is a review for medical necessity
Q26: Some managed care plans contract out utilization
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