In health plan terminology, demand management, as used by health plans, can best be described as
A) an evaluation of the medical necessity, efficiency, and/or appropriateness of healthcare services and treatment plans for a given patient
B) a series of strategies designed to reduce plan members' needs to utilize healthcare services by encouraging preventive care, wellness, member self-care, and appropriate use of healthcare services
C) a technique that prevents a provider who is being reimbursed under a fee schedule arrangement from billing a plan member for any fees that exceed the maximum fee reimbursed by the plan
D) a system of identifying plan members with special healthcare needs, developing a healthcare strategy to meet those needs, and coordinating and monitoring the care
Correct Answer:
Verified
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