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In Health Plan Terminology, Demand Management, as Used by Health

Question 181

Multiple Choice

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

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