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NEW QUESTION: 1
The method that the Autumn Health Plan uses for reimbursing dermatologists in its provider network involves paying them out of a fixed pool of funds that is actuarially determined for this specialty. The amount of funds that Autumn allocates to dermatologists is based on utilization and costs of services for that discipline.
Under this reimbursement method, a dermatologist who is under contract to Autumn accumulates one point for each new referral made to the specialist by Autumn's PCPs. If the referral is classified as complicated, then the dermatologist receives 1.5 points. The value of Autumn's dermatology services fund for the first quarter was $15,000. During the quarter, Autumn's PCPs made 90 referrals, and 20 of these referrals were classified as complicated.
Autumn's method of reimbursing specialty providers can best be described as a
A. Withhold arrangement
B. Risk adjustment arrangement
C. Contact capitation arrangement
D. Disease-specific arrangement
Answer: C

NEW QUESTION: 2
Which of the following does NOT come under the consideration of systematic or interconnection risk?
A. Contingency plans setting forth actions to be taken when system-wise market disruptions occur
B. Due diligence of enforcement activities
C. Risk management systems that include limits or controls on interconnection risk to which the entity is willing to expose itself.
D. Provisions for monitoring systematic risk effectively
Answer: B

NEW QUESTION: 3
You are configuring a SharePoint environment to support workflows. Workflows must meet the
following requirements:
Display a visual representation of the workflow.
Display the workflow history.
Provide access to external lists. You need to implement the necessary shared services.
Which shared services should you implement? (Each correct answer presents part of the solution.
Choose two.)
A. Business Data Connectivity Services
B. Workflow Services
C. Access Services
D. Word Automation Services
E. Visio Graphics Services
Answer: A,D,E