Dr. Sarah Carmichael is one of several network providers who serve on one of the Apex Health Plan's organizational committees. The committee reviews cases against providers identified through complaints and grievances or through clinical monitoring activities. If needed, the committee formulates, approves, and monitors corrective action plans for providers. Although Apex administrators and other employees also serve on the committee, only participating providers have voting rights. The committee that Dr. Carmichael serves on is a
A) Utilization management committee
B) Peer review committee
C) Medical advisory committee
D) Credentialing committee

Question

Quizplus · Accepted Answer

Dr. Sarah Carmichael serves on a committee that reviews cases against providers and formulates corrective action plans for providers. This is the description of a peer review committee, which is focused on evaluating the quality of care provided by network providers. The other choices, utilization management, medical advisory, and credentialing committees, have different functions within a healthcare network.

Dr Sarah Carmichael Is One of Several Network Providers Who