Practice Quiz

Managed Care Nursing

Category - Healthcare Management

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Which of the following statements is incorrect regarding an external quality review?
  1. Aggregated quality data is used
  2. Data set includes access to care
  3. Data set includes timeliness of care
  4. Data is collected based on patients with private and non-governmental insurance
  5. Data is based on MCO or PIHP or contractor regarding care provided
Explanation
Answer: D - The external quality review does not include data collection based on patients with private and non-governmental insurance.

An external quality review is aggregated quality data based on timeliness and access to care provided by MOC or PIHP or contractors to Medicaid patients.
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