What is an organization hired by a payer to evaluate medical necessity called?
A) exploitation review organization
B) utilization review organization
C) application review organization
D) operation review organization
Correct Answer:
Verified
Q38: The payer's process for determining medical necessity
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
Q44: _ is preauthorization for hospital admission or
Q45: Another term for precertification is _.
A) pre-documentation
B)
Q46: Who sends the claim to the BlueCross
Q47: Who sends the claim to BlueCross and
Q48: The BCBS Blue Card program provides benefits
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