Which involves the development of patient care plans for the coordination and provision of care for complicated cases in a cost-effective manner?
a. case management
b. risk management
c. quality management
d. utilization management
Question 2
Some managed care plans contract out utilization management services to a utilization review organization (URO), which is an entity that __________.
a. conducts a quality management program and completes focused review studies and medical audits
b. establishes a utilization management program and performs external utilization review services
c. performs risk management activities that result in appropriate in-service education for medical staff
d. provides a service to the organization to ensure that physicians have met credentialing requirements
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