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In certain situations, a health plan can use the results of utilization review to intervene, if necessary, to alter the course of a plan member's medical care. Such intervention can be based on the results of
Suggested Answer: D
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28 comments · newest first
NI
Nidia
8 months ago
I’m not sure, but B only feels too limited. Maybe D is safer.
YO
Youlanda
9 months ago
I lean towards D too. All reviews are important for intervention.
SC
Scot
9 months ago
I feel like A and B are the most relevant. So, E seems right.
KR
Krystina
9 months ago
Not sure if I trust them to intervene like that.
CA
Carri
9 months ago
Totally agree, it's all about A, B, and C!
CO
Coral
9 months ago
Wait, can they really change your treatment like that?
ES
Estrella
9 months ago
I think it's just A and B, though.
SH
Shakira
10 months ago
D. Easy peasy, lemon squeezy.
LI
Ligia
10 months ago
D is the way to go. Gotta love that comprehensive answer!
EL
Ellsworth
10 months ago
Definitely D. Utilization review can be used for prospective, concurrent, and retrospective interventions.
MI
Micah
10 months ago
I’m a bit confused about whether retrospective review plays a role here. I thought it was only A and B that mattered for intervention.
JI
Jill
10 months ago
I feel like concurrent review is definitely important for ongoing care, but I can't recall if both A and B are necessary for intervention.
CH
Chuck
10 months ago
D. A, B, and C are all correct.
CO
Cordelia
11 months ago
I think the answer is D. A, B, and C cover all bases.
EL
Elza
11 months ago
Definitely A, B, and C!
AL
Alease
11 months ago
I practiced a question similar to this, and I think it was about using both prospective and concurrent reviews for effective intervention.
KA
Karina
11 months ago
I'm going with D. Covers all the bases.
OR
Ora
11 months ago
I think I remember that prospective review is about assessing care before it happens, but I'm not sure if that alone is enough for intervention.
FI
Filiberto
12 months ago
Hmm, I think I know the answer, but I want to double-check my understanding. Let me quickly review the key differences between prospective, concurrent, and retrospective review to make sure I'm on the right track.
MA
Marguerita
12 months ago
This is a good opportunity to showcase my knowledge of utilization review. I'll methodically go through each answer choice and evaluate how the different types of review could be used to intervene in a member's care.
MI
Michal
1 year ago
I'm a little confused by the wording here. What exactly do they mean by "intervene" in the member's care? I'll need to make sure I understand that before I can determine which type(s) of review would be appropriate.
ER
Erin
1 year ago
Okay, I've got this. The question is asking about the specific types of utilization review that can be used to intervene in a member's care. I'll need to carefully consider the differences between prospective, concurrent, and retrospective review.
SH
Shaquana
1 year ago
Hmm, this seems like a tricky one. I'll need to think through the different types of utilization review and how they might be used to intervene in a member's care.
AL
Alysa
7 months ago
I’m leaning towards D as well. Better to be thorough!
YO
Youlanda
7 months ago
True, but sometimes less is more. A and B might be enough.
ED
Edda
7 months ago
I feel like D covers all bases. Why not include everything?
NO
Norah
8 months ago
Yeah, but what about C? Isn't that important too?
KA
Katina
8 months ago
I think it's definitely A and B. Those are the main ones, right?