Health plans often program into their claims processing systems certain criteria that, if unmet, will prompt further investigation of a claim. In an automated claims processing system, these criteria may signal the need for further review when, for example
Answer(s): D
Health plans require utilization review for all services administered by its participating physicians.
Answer(s): B
Health plans sometimes contract with independent organizations to provide specialty services, such as vision care or rehabilitation services, to plan members. Specialty services that have certain characteristics are generally good candidates for health pl
Health plans' use of the Internet to provide plan members with health-related information has grown rapidly in recent years. One advantage the Internet has over other forms of communication is that
Answer(s): A
Health plans use the following to determine the number of providers to add to a network:
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q252: dns poisoning is the correct answer, not locator redirection. beaconing is detected from a host. this indicates that the system has been infected with malware, which could be the source of local dns poisoning. location redirection works by either embedding the redirection in the original websites code or having a user click on a url that has an embedded redirect. since users at a different office are not getting redirected, it isnt an embedded redirection on the original website and since the user is manually typing in the url and not clicking a link, it isnt a modified link.
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