The payer's process for determining medical necessity is called _____.
A) exploitation review
B) relevance review
C) applicability review
D) utilization review
Correct Answer:
Verified
Q33: _ links participating providers and independent BCBS
Q34: Participating provider's local BCBS plan is called
Q35: _ is BCBS plan in the subscriber's
Q36: _ is BCBS consumer-driven health plan that
Q37: The types of services that the provider
Q39: When the practice decides to participate in
Q40: What is protection against large losses or
Q41: Nonemergency surgical procedure is called _.
A) discretionary
Q42: What determines whether a participating provider can
Q43: What is an organization hired by a
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