A payer needs to work with plan members and medical providers to influence decisions through a case-by-case review of the appropriateness of care.
When gathering requirements for this use case, which two Utilization Management processes should a consultant discuss with the client? (Choose two.)
A
Designing Next Best Action and Recommendations for the care management team
B
Designing Care Requests to seek authorization from a health plan for drugs, services, and admissions
C
Considering the number of intake agents who will be using Health Cloud
D
Considering the Request Review Types; Prior Authorization Review, Concurrent Review, and Retrospective Review
Show Answer
