This assessment validates applied knowledge in healthcare practice and standards, including safe practice, professional standards, and evidence-based decision-making. It is intended for candidates entering or advancing in healthcare-related roles.
Although the process is voluntary for health plans, external accreditation is becoming more and more important as states and purchasers require health plans undergo some type of external review process. This process:
Amendments to the HMO act 1973 do not permit federally qualified HMO’s to use
An exclusive provider organization (EPO) operates much like a PPO. However, one difference between an EPO and a PPO is that an EPO
An HMO that combines characteristics of two or more HMO models is sometimes referred to as a
Appropriateness of treatment provided is determined by developing criteria that if unmet will prompt further investigation of a claim which are also called: