If water is flowing into the tank at the rate of 120gallons per hour and flowing out of the tank at aconstant rate of one gallon per minute, the water levelin the tank will(A) fall 1 gallon per minute.(B) fall 2 gallons per minute.(C) remain the same.(D) rise 2 gallons per minute.(E) rise 1 gallon per minute. 15.
Definition of Terms. In compliance with State requirements, ValueOptions defines the following terms related to. Enrollee or Provider concerns with the NorthSTAR program: Administrative Denial: A denial of services, or claims payment for services, based on reasons other. than a lack of medical necessity. Administrative Appeal: A request by an Enrollee, Enrollee-designated representative, or provider to. reconsider an administrative denial. Adverse Determination: A determination that the health care services requested or proposed to be. provided to an Enrollee are not medically necessary.
Denial management is the catch-all phrase for any process that practices hope can lead to cleaner claims and fewer denials from insurers. Experts say denial management can be part of an entire electronic medical record/billing system, or it can be a bolt-on to an existing system. It can be a Web-based system that reviews claims. It can also be a manual, retroactive review of denied claims.