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One way that health plans evaluate their UR programs is by monitoring utilization rates.

One way that health plans evaluate their UR programs is by monitoring utilization rates. By definition, utilization rates typically

A.

indicate changes in the total amount of medical expenses or claim dollars paid for particular procedures

B.

measure the number of services provided per 1,000 members per year

C.

indicate standard approaches to care for many common, uncomplicated healthcare services

D.

report the number of times that a particular provider performs or recommends a service excluded from the benefit plan

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