The nature of behavioral healthcare creates unique medical management challenges for health plans. One method health plans have used to support the delivery of appropriate services in a cost-effective manner is to
Answer : B
One way that health plans can make their benefits more appealing to employers and employees is to offer coverage for specialty services. It is correct to say that specialty services typically
Answer : D
PBMs are accredited by the same organizations that accredit health plans.
Answer : B
All states have laws describing the conditions under which pharmacists can substitute a generic drug for a brand-name drug. With respect to these laws, it is correct to say that in every state,
Answer : D
DUR can be conducted prospectively, concurrently, or retrospectively. One true statement about prospective DUR is that it
Answer : C
One of the steps in drug utilization review (DUR) is defining optimal drug use, which can be accomplished by applying diagnosis criteria and drug-specific criteria. Drug-specific criteria are standards that identify the
Answer : A
7. One method that health plans use to address provider compliance with formularies is academic detailing.
Answer : A