QUESTION 4

Risk is generally predictable for

	a.	individuals
	b.	providers
	c.	groups of people
	d.	underwriters

2 points

QUESTION 5

Accreditation of managed care organizations is a form of oversight in which an outside organization reviews an MCO and determines if it meets certain criteria. The three main accreditation organization are the National Committee for Quality Assurance (NCQA), Utilization Review Accreditation Commission URAC and

	a.	AAAHC
	b.	HIPAA
	c.	HEDIS
	d.	ERISA

3 points

QUESTION 6

Many employers self insure primarily to avoid having their benefits plan subject to these laws and regulations. True or False

True

False

3 points

QUESTION 7

The first function of the _________________ is to capture the claim.

	a.	Member services department
	b.	Marketing department
	c.	Sales department
	d.	Claims department