- (Topic 2)
Members who qualify to participate in a health plan's case management program are typically assigned a case manager. During the course of the member's treatment, the case manager is responsible for

1. A. Coordinating and monitoring the member's care
2. B. Approve
3. C. Both A and B
4. D. A only
5. E. B only
6. F. Neither A nor B

Correct Answer: B

- (Topic 1)
From the following answer choices, choose the description of the ethical principle that best corresponds to the term Autonomy

1. A. Health plans and their providers are obligated not to harm their members
2. B. Health plans and their providers should treat each member in a manner that respects the member's goals and values, and they also have a duty to promote the good of the members as a group
3. C. Health plans and their providers should allocate resources in a way that fairly distributes benefits and burdens among the members
4. D. Health plans and their providers have a duty to respect the right of their members to make decisions about the course of their lives

Correct Answer: D

- (Topic 1)
For this question, select the answer choice containing the terms that correctly complete the blanks labeled A and B in the paragraph below.
NCQA offers Quality Compass, a national database of performance and accreditation information submitted by managed

1. A. Health Plan Employer Data and Information Set (HEDIS) mandatory
2. B. Health Plan Employer Data and Information Set (HEDIS) voluntary
3. C. ORYX mandatory
4. D. ORYX voluntary

Correct Answer: B

- (Topic 3)
The participating physicians remain independent practitioners who operate out of their own offices and can treat other patients in addition to Kayak plan members. Kayak can correctly be characterized as

1. A. a closed-panel HMO
2. B. an open-panel HMO
3. C. a direct contract model HMO
4. D. a dual choice HMO

Correct Answer: B

- (Topic 3)
A differences between managed indemnity & traditional indemnity

1. A. Include precertification and utilization review techniques
2. B. Both are the same
3. C. Include network and quality review techniques
4. D. A & B

Correct Answer: C