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Arthur Dace, a plan member of the Bloom health plan, tried repeatedly over an extended period to schedule an appointment with Dr. Pyle, his primary care physician (PCP). Mr. Dace informally surveyed other Bloom plan members and found that many people were experiencing similar problems getting an appointment with this particular provider. Mr. Dace threatened to take legal action against Bloom, alleging that the health plan had deliberately allowed a large number of patients to select Dr. Pyle as their PCP, thus making it difficult for patients to make appointments with Dr. Pyle.
Bloom recommended, and Mr. Dace agreed to use, an alternative dispute resolution (ADR) method that is quicker and less expensive than litigation. Under this ADR method, both Bloom and Mr. Dace presented their evidence to a panel of medical and legal experts, who issued a decision that Bloom's utilization management practices in this case did not constitute a form of abuse. The panel's decision is legally binding on both parties.
Different types of compensation arrangements in managed care plans, from fee-for-service (FFS) arrangements to capitation arrangements, lead to different types of fraud and abuse. From the answer choices below, select the response that identifies the form of abuse in which Bloom is allegedly engaging, according to Mr. Dace's complaint, and whether this form of abuse is more likely to occur in FFS compensation arrangements or in capitation arrangements.
A. Type of abuse overutilization Type of compensation arrangement FFS arrangement
B. Type of abuse underutilization Type of compensation arrangement capitation arrangement
C. Type of abuse underutilization Type of compensation arrangement FFS arrangement
D. Type of abuse overutilization Type of compensation arrangement capitation arrangement
Answer: B
You need to recommend which tasks must be performed to meet the technical requirements of the research and development (R&D) department.
Which two tasks should you recommend? (Each correct answer presents part of the solution. Choose two.)
A. Create an OAB virtual directory.
B. Create a new global address list (GAL) and a new address book policy.
C. Run the Set-Mailbox cmdlet.
D. Run the Update AddressList cmdlet.
E. Modify the permissions of the default global address list (GAL), and then create a new
GAL.
Answer: B,C
Which protocol is used for voice bearer traffic?
A. RTP
B. SCCP
C. CDP
D. ICMP
E. MGCP
Answer: A
Explanation:
Explanation/Reference:
Explanation:
VoIP Control and Transport Protocols
A number of different protocols are used in a VoIP environment for call control, device provisioning, and
addressing.
Figure 14-15 shows those protocols focused on VoIP control and transport.
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