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Medicare beneficiaries can obtain healthcare benefits through fee-for-service (FFS) Medicare programs, Medicare medical savings account (MSA) plans, Medigap insurance, or coordinated care plans (CCPs). Unlike other coverage options, CCPs
Examples of alternative healthcare practitioners are chiropractors, naturopaths, and acupuncturists. The only well-established credentialing standards for alternative healthcare practitioners are those available from NCQ A. These NCQA credentialing standards apply to
The following statement(s) can correctly be made about the scope of case management:
1. Case management incorporates activities that may fall outside a health plan’s typical
responsibilities, such as assessing a member’s financial situation
2. Case management generally requires a less comprehensive and complex approach to a course
of care than does utilization review
3. Case management is currently applicable only to medical conditions that require inpatient
hospital care and are categorized as catastrophic in terms of health and/or costs
Michelle Durden, who is enrolled in a dental health maintenance organizations (DHMO) offered by her employer, is due for a routine dental examination. If the plan is typical of most DHMOs, then Ms. Durden
Demetrius Farrell, age 82, is suffering from a terminal illness and has consulted his health plan
about the care options available to him. In order to avoid unwanted, futile interventions, Mr. Farrell
signed an advance directive that indicates the types of end-of-life medical treatment he wants to
receive. His family is to use this document as a guide should Mr. Farrell become incapacitated.
For this question, if answer choices (A) through (C) are all correct, select answer choice (D).
Otherwise, select the one correct answer choice.
Decisions regarding Mr. Farrell’s end-of-life care are legally the right and responsibility of
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