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Question ID 21626

To see that utilization guidelines are consistently applied, UR programs rely on
authorization systems. Determine whether the following statement about authorization
systems is true or false:
Only physicians can make nonauthorization decisions based on medical necessity.

Option A

True

Option B

 False

Correct Answer A
Explanation


Question ID 21627

Health plans often use accreditation as a means of evaluating the quality of care delivered
to plan members. Accreditation of subacute care providers is available from the

Option A

National Committee for Quality Assurance (NCQA)

Option B

Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

Option C

 American Accreditation HealthCare Commission/URAC (URAC)

Option D

Foundation for Accountability (FACCT)

Correct Answer B
Explanation

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