[2017-7-NEW From Google Drive] Prepare for Free Updated Microsoft Specialist 70-475 PDF with Latest and Valid 70-475 Study Guide Reviews Youtube Study

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Exam Code: 70-475
Exam Name: Designing and Implementing Big Data Analytics Solutions
Updated: Jul 25, 2017
Q&As: 70

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Pass4itsure Latest and Most Accurate Microsoft 70-475 PDF Dumps Exam Q&As:

One method of transferring the information in electronic medical records (EMRs) is through a health
information network (HIN). The following statements are about HINs. Three of the statements are true and
one is false. Select the answer choice containing the FALSE statement.
A. A HIN may afford a health plan better measurements of outcomes and provider performance.
B. The use of a HIN typically increases a health plan’s exposure to liability for poor care.
C. Most HINs are Internet-based rather than built on proprietary computer networks.
D. Currently, the majority of health plans do not have HINs that are capable of transferring medical
records among their network providers.
70-475 pdf Correct Answer: B
One true statement about state regulation of case management activities is that the majority of states
A. have enacted laws that list specific quality management requirements for a case management program
B. consider case management files to be medical records that must be retained for a specified length of
C. view case management similarly and follow similar patterns with their laws and regulations
D. have enacted laws or regulations requiring licensure or certification of case managers
Correct Answer: B
CMS has developed two prototype programs–Programs of All-inclusive Care for the Elderly (PACE) and
the Social Health Maintenance Organization (SHMO) demonstration project–to deliver healthcare services
to Medicare beneficiaries. From the answer choices below, select the response that correctly identifies the
features of these programs.
A. PACE-annual limits on benefits for nursing home and community-based care SHMO-no limits on long
term care benefits
B. PACE-provide long-term care only SHMO-provide acute and long-term care
C. PACE-enrollees must be age 65 or older SHMO-enrollees must be age 55 or older
D. PACE-enrollment open to nursing home certifiable Medicare beneficiaries only SHMO- enrollment
open to all Medicare beneficiaries
70-475 dumps Correct Answer: D
The American Accreditation HealthCare Commission/URAC (URAC) has an accreditation program
specifically for case management services. From the answer choices below, select the response that
correctly identifies the type(s) of case management services addressed by URAC’s standards and the type
(s) of organizations to which these standards may be applied.
A. Type(s) of Services-on-site services only Type(s) of Organization-health plans only
B. Type(s) of Services-on-site services only Type(s) of Organization-any organization that performs case
management functions
C. Type(s) of Services-both telephonic and on-site services Type(s) of Organization-health plans only
D. Type(s) of Services-both telephonic and on-site services Type(s) of Organization-any organization that
performs case management functions
Correct Answer: D
The paragraph below contains an incomplete statement. Select the answer choice containing the term that
correctly completes the paragraph.

Medical management programs often require the analysis of many types of data and information.
__________________ is an automated process that analyzes variables to help detect patterns and
relationships in the data.
A. Unbundling
B. Outsourcing
C. Data mining
D. Drilling down
70-475 exam Correct Answer: C
Elaine Newman suffered an acute asthma attack and was taken to a hospital emergency department for
treatment. Because Ms. Newman’s condition had not improved enough following treatment to warrant
immediate release, she was transferred to an observation care unit. Transferring Ms. Newman to the
observation care unit most likely
A. resulted in unnecessarily expensive charges for treatment
B. prevented Ms. Newman from receiving immediate attention for her condition
C. gave Ms. Newman access to more effective and efficient treatment than she could have obtained from
other providers in the same region
D. allowed clinical staff an opportunity to determine whether Ms. Newman required hospitalization without
actually admitting her
Correct Answer: D
The following statements describe situations in which health plan members have medical problems that
require care. Select the statement that describes a situation in which self- care most likely would not be
A. Two days after bruising her leg, Avis Bennet notices that the pain from the bruise has increased and
that there are red streaks and swelling around the bruised area.
B. Calvin Dodd has Type II diabetes and requires blood glucose monitoring tests several times each day.
C. Caroline Evans has severe arthritis that requires regular exercise and oral medication to reduce pain
and help her maintain mobility.
D. Oscar Gracken is recovering from a heart attack and requires ongoing cardiac rehabilitation.
70-475 vce Correct Answer: A
The following statement(s) can correctly be made about medical management considerations for the
Federal Employee Health Benefits Program (FEHBP):
1.FEHBP plan members who have exhausted the health plan’s usual appeals process for a disputed
decision can request an independent review by the Office of Personnel Management (OPM)
2.All health plans that cover federal employees are required to develop and implement patient safety
A. Both 1 and 2
B. 1 only
C. 2 only
D. Neither 1 nor 2
Correct Answer: A
Three general categories of coverage policy–medical policy, benefits administration policy, and
administrative policy–are used in conjunction with purchaser contracts to determine a health plan’s
coverage of healthcare services and supplies. With respect to the characteristics of the three types of
coverage policy, it is correct to say that a health plan’s
A. medical policy evaluates clinical services against specific benefits language rather than against
scientific evidence
B. benefits administration policy determines whether a particular service is experimental or investigational
C. benefits administration policy focuses on both clinical and nonclinical coverage issues
D. administrative policy contains the guidelines to be followed when handling member and provider
complaints and disputes
70-475 pdf Correct Answer: D
The following statements are about health plans’ complaint resolution procedures (CRPs). Three of the
statements are true and one is false. Select the answer choice containing the FALSE statement.
A. An health plan’s CRPs reduce the likelihood of errors in decision making.
B. CRPs typically provide for at least two levels of appeal for formal appeals.
C. CRPs include only formal appeals and do not apply to informal complaints.
D. Most complaints are resolved without proceeding through the entire CRP process.
Correct Answer: C
Health plans that offer complementary and alternative medicine (CAM) services face potential liability
because many types of CAM services
A. must be offered as separate supplemental benefits or separate products
B. lack clinical trials to evaluate their safety and effectiveness
C. are not covered by state or federal consumer protection statutes
D. focus on a specific illness, injury, or symptom rather than on the whole body
70-475 vce Correct Answer: B
In order for a health plan’s performance-based quality improvement programs to be effective, the desired
outcomes must be
A. achievable within a specified timeframe
B. defined in terms of multiple results
C. expressed in subjective, qualitative terms
D. all of the above
Correct Answer: A
The following statement(s) can correctly be made about performance measurement systems:
1.The most difficult purpose for a performance measurement system to address is to measure changes in
outcomes caused by modifications in administrative or clinical treatment processes
2.A health plan needs different performance measurement systems to evaluate its administrative services
and the clinical performance of its providers
A. Both 1 and 2
B. 1 only

C. 2 only
D. Neither 1 nor 2
70-475 dumps Correct Answer: C
Home healthcare encompasses a wide variety of medical, social, and support services delivered at the
homes of patients who are disabled, chronically ill, or terminally ill. The time period(s) when health plans
typically use home healthcare include
1.The period prior to a hospital admission
2.The period following discharge from a hospital
A. Both 1 and 2
B. 1 only
C. 2 only
D. Neither 1 nor 2
Correct Answer: A
Designing effective medical management programs for Medicare beneficiaries requires an understanding
of the unique health needs of the Medicare population. One characteristic of Medicare beneficiaries is that
they typically
A. do not experience mental health problems
B. consume more than half of all prescription drugs
C. are likely to equate quality with the technical aspects of clinical procedures
D. require longer and more costly recovery periods following acute illnesses or injuries than does the
general population
70-475 exam Correct Answer: D

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