Cmom module 5 Study guides, Class notes & Summaries

CMOM Module 5 Questions with Answers MCO Coordinator functions - Answer-1) Patient training and education 2)HMO intermediary 3)Hospitalization approvals and discharge planning 4) coordinating referrals 5)patient satisfaction surveys 6)coordinating with physician in utilization review committee 7)coordinating quality assurance data needed by MCO or other regulatory agency Utilization review committee - Answer-should be used to review all cases which may need to be referred to a speciali...

CMOM Module 5 Exam | Questions And Answers Latest {} A+ Graded | 100% Verified

Credentialing - verifies that a physician meets standards through the review of license, experience, certification, education, training, malpractice and adverse clinical occurrences, clinical judgement and character via investigation and observation Privileging - Defines a physician's scope of practice and the clinical services he or she may provide Council for Affordable Quality HealthCare (CAQH) - not-for-profit collaborative alliance of health plans and networks which offers a standard...

CMOM Module 5| with Questions & Correct Verified Answers

CMOM Certification Study Set Module 4 Questions and Answers Medicare Incentive Reward Program (IRP) - Answer-established to pay an incentive reward to individuals who provide information on Medicare fraud and abuse or other sanctionable activities Medicare Contract Statutory Obligations - Answer-Services must be furnished (1) economically and only when and to the extent (2) medically necessary; of a (3) quality that meets professionally recognized standards of health care; and (4) supported ...

PMI CMOM Module 4 Questions with Answers Health Care/Health Care Provider - Answer-Care, services or supplies related to health of individual. Preventative, diagnostic, therapeutic, rehabilitative or palliative care and counseling, service, assessment or procedure. Dispensing of prescriptions. Provider of medical or health services, and any person or organization who furnishes, bills or is paid for health care Heath Information - Answer-Any information oral or recorded in any form or med...