A health insurance specialist reviews health-related claims to determine, based on a patient's diagnoses and procedures:

A health insurance specialist reviews health-related claims to determine, based on a patient's diagnoses and procedures:


a. whether the costs are reasonable and medically necessary.

b. to ensure that the patient's treatment is effective.

c. to report findings to government agencies.

d. actuarial tables



Answer: a. whether the costs are reasonable and medically necessary.


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