Determine the criteria for participation in the network

Assignment Help Operation Management
Reference no: EM131851437

The Lehman health plan an MCO is currently recruiting providers in preparations for its expansion into a new service area. A recruiter for Lehman has been meeting with DR. Anthony Smith a pediatrician who practices in Lehman's new service area, in order to convice him to become one of the plan's providers.

While these meeting have been taking place, Lehman has been obtaining, reviweing, and verifying Dr. Smiths documentation related to licenses, certifications and training in order to determine whether he meets lehman's pre- established criteria for participation in its provider network.

The process by which lehman determines whether Dr. smith meets its pre- established criteria for participation in its provider network.

The process by which lehman determines whether Dr. smith meets its pre- established criteria for participation in the network is known as:

1. Quality Assurance

2. ERISA

3. Credentialing

4.Accreditation

Reference no: EM131851437

Questions Cloud

Create a small family database with one table : Create a small Family database with one table to include data about members of your family. Include data fields such as family member number and first name.
How does a table adapter differ from a data adapter : What happens when you drag a dataset table from the Data Sources window onto a blank form? How does a table adapter differ from a data adapter?
How does your lifestyle affect the behavior : How does your lifestyle affect the behavior you want to change Behavior that i want to change is (reducing/stopping consumption of alcoholic drinks)
How the dataset table adapter and a data grid object are use : Explain how the dataset, table adapter, and a data grid object are used to update a database.
Determine the criteria for participation in the network : The process by which lehman determines whether Dr. smith meets its pre- established criteria for participation in its provider network.
What might stephanie determine as the best production : The department operates five days a week. One complexity is that partially completed safes are not permitted; each cycle must turn out finished units.
Write a paper on gobeklitepe : Write a paper on Gobeklitepe - Please use your book as your primary source and refer to it in your writing. Use a quote or two the best support your points
What do you think management at renault should have : What do you think management at Renault should have done about the anonymous accusation about a senior official negotiating a bribe?
Show that a symmetric noisy-or model : Show that both a symmetric noisy-or model and a symmetric logistic model can be formulated easily using an aggregator CPDs.

Reviews

Write a Review

Operation Management Questions & Answers

  Book review - the goal

Operations Management is about a book review. Title of the book is "Goal". This book has been written by Dr. Eliyahu Goldartt. The book has been appreciated by many as one of those books which offers an insight into the operations and strategic capac..

  Operational plan in hospitality enterprise

Operational plan pertaining to a hospitality enterprise is given in detail in the solution. The operational plan is an important plan or preparation which gives guidelines regarding the role and responsibilities of each and every operation at all lev..

  Managing operations and information

Recognise the importance of a strategic approach to the development and deployment of organisational information systems. Demonstrate an understanding of the importance of databases and their integration to the organisation's overall information mana..

  A make-or-buy analysis

An analysis of the holding costs, including the appropriate annual holding cost rate.

  Evolution and contributor of operations management

Briefly explain Evolution and contributor of Operations management.

  Functions and responsibilities of an operations manager

A number of drivers of change have transformed the roles, functions and responsibilities of an operations manager over recent years. These drivers have not only been based on technological innovations but also on the need for organisations to develop..

  Compute the optimal order quantity

Compute the Optimal Order quantity of DVD players. Determine the appropriate reorder point.

  Relationship to operations practice in the organisation

Evaluate problems in operations and identify approaches to overcoming them. Critically evaluate operating plans and identify areas for improvement. Justify, implement and evaluate changes to operations in line with modern approaches.

  A make or buy analysis

Develop a report for Figi Fabricating that will address the question of whether the company should continue to purchase the part from the supplier or begin to produce the part itself.

  Prepare a staffing plan

Prepare a staffing plan showing the change of your unit from medical/surgical staffing to oncology staffing.

  Leadership styles in different organizations

Ccompare the effectiveness of different leadership styles in different organizations

  Risk management tools and models

Be able to understand the concept of risk, roles and responsibilities for risk management and risk management tools and models.

Free Assignment Quote

Assured A++ Grade

Get guaranteed satisfaction & time on delivery in every assignment order you paid with us! We ensure premium quality solution document along with free turntin report!

All rights reserved! Copyrights ©2019-2020 ExpertsMind IT Educational Pvt Ltd