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NEW QUESTION: 1
The following statements describe two types of HMOs:
The Elm HMO requires its members to select a PCP but allows the members to go to any other provider on its panel without a referral from the PCP.
The Treble HMO does not require its members to select a PCP. Treble allows its members to go to any doctor, healthcare professional, or facility that is on its panel without a referral from a primary care doctor. However, care outside of Treble's network is not reimbursed unless the provider obtains advance approval from the HMO.
Both HMOs use delegation to transfer certain functions to other organizations. Following the guidelines established by the NCQA, Elm delegated its credentialing activities to the NewnanGroup, and the agreement between Elm and Newnan lists the responsibilities of both parties under the agreement. Treble delegated utilization management (UM) to an IPA. The IPA then transferred the authority for case management to the Quest Group, an organization that specializes in case management.
Both HMOs also offer pharmacy benefits. Elm calculates its drug costs according to a pricing system that requires establishing a purchasing profile for each pharmacy and basing reimbursement on the profile. Treble and the Manor Pharmaceutical Group have an arrangement that requires the use of a typical maximum allowable cost (MAC) pricing system to calculate generic drug costs under Treble's pharmacy program. The following statements describe generic drugs prescribed for Treble plan members who are covered by Treble's pharmacy benefits:
The MAC list for Drug A specifies a cost of 12 cents per tablet, but Manor pays 14 cents per tablet for this drug.
The MAC list for Drug B specifies a cost of 7 cents per tablet, but Manor pays 5 cents per tablet for this drug.
The following statements can correctly be made about the reimbursement for Drugs A and B under the MAC pricing system:
A. Treble most likely is obligated to reimburse Manor 14 cents per tablet for Drug
B. Manor most likely is allowed to bill the subscriber 2 cents per tablet for Drug A.
C. All of the above statements are correct.
D. Treble most likely is obligated to reimburse Manor 5 cents per tablet for Drug B.
Answer: D

NEW QUESTION: 2
A security analyst has been asked to scan a subnet. During the scan, the following output was generated:

Based on the output above, which of the following is MOST likely?
A. 192.168.100.145 is a DNS server
B. 192.168.100.214 is a web server
C. 192.168.100.214 is a secure FTP server
D. Both hosts are mail servers
Answer: B

NEW QUESTION: 3
When booting up the EMC Storage Array, how long should you expect the boot up procedure to take?
A. 5 minutes
B. 10 minutes
C. 30 minutes
D. 20 minutes
Answer: A

NEW QUESTION: 4
Auditors testing mutual funds transactions will typically focus on whether customer purchases and redemptions are accounted properly. In cases where brokers are used to maintain customer accounts, auditors may need to confirm:
A. The number of shares held by the broker
B. The number of shares held by the mutual fund
C. The number of shares held by the dealer
D. The number of shares held by the shareholder itself
Answer: A