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AHM-250 Healthcare Management: An Introduction is now Stable and With Pass Result | Test Your Knowledge for Free

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AHM-250 Practice Questions

Healthcare Management: An Introduction

Last Update 12 hours ago
Total Questions : 367

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Question # 11

From the answer choices below, select the response that correctly identifies the rating method that Mr. Sybex used and the premium rate PMPM that Mr. Sybex calculated for the Koster group.

Options:

A.  

Rating Method book rating Premium Rate PMPM $132

B.  

Rating Method book rating Premium Rate PMPM $138

C.  

Rating Method blended rating Premium Rate PMPM $132

D.  

Rating Method blended rating Premium Rate PMPM $138

Discussion 0
Question # 12

Health plans require utilization review for all services administered by its participating physicians.

Options:

A.  

True

B.  

False

Discussion 0
Question # 13

Arthur Moyer is covered under his employer's group health plan, which must comply with the Consolidated Omnibus Budget Reconciliation Act (COBRA). Mr. Moyer is terminating his employment. He has elected to continue his coverage under his employer's group

Options:

A.  

18 months, but his coverage under COBRA will cease if he obtains group health coverage through another employer.

B.  

18 months, even if he obtains group health coverage through another employer.

C.  

36 months, but his coverage under COBRA will cease if he obtains group health coverage through another employer.

D.  

36 months, even if he obtains group health coverage through another employer.

Discussion 0
Question # 14

Health plans can organize under a not-for-profit form or a for-profit form. One true statement regarding not-for-profit health plans is that these organizations typically

Options:

A.  

are exempt from review by the Internal Revenue Service (IRS)

B.  

are organized as stock companies for greater flexibility in raising capital

C.  

rely on income from operations for the large cash outlays needed to fund long-term projects and expansion

D.  

engage in lobbying or political activities in order to maintain their tax-exempt status

Discussion 0
Question # 15

In certain situations, a health plan can use the results of utilization review to intervene, if necessary, to alter the course of a plan member's medical care. Such intervention can be based on the results of

Options:

A.  

Prospective review

B.  

Concurrent review

C.  

D.  

A, B, and C

E.  

A and B only

F.  

A and C only

G.  

B only

Discussion 0
Question # 16

In order to measure the expenses of institutional utilization, Holt Healthcare Group uses the standard formula to calculate hospital bed days per 1,000 plan members per year. On October 23, Holt used the following information to calculate the bed days per

Options:

A.  

278

B.  

397

C.  

403

D.  

920

Discussion 0
Question # 17

By offering a comprehensive set of healthcare benefits to its members, an HMO ensures that its members obtain quality, cost-effective, and appropriate medical care. Ways that an HMO provides comprehensive care include

Options:

A.  

coordinating care across a variety of benefits

B.  

emphasizing preventive care by covering many preventive services either in full or with a small copayment

C.  

offering its members access to wellness programs

D.  

All of the above

Discussion 0
Question # 18

Greentree Medical, a health plan, is currently recruiting PCPs in preparation for its expansion into a new service area. Abigail Davis, a recruiter for Greentree, has been meeting with Melissa Cortelyou, M.

D.  

, in an effort to recruit her as a PCP in Green

Options:

A.  

Greentree is prevented by law from offering a contract to Dr. Cortelyou until the credentialing process is complete

B.  

any contract signed by Dr. Cortelyou should include a clause requiring the successful completion of the credentialing process within a defined time frame in order for the contract to be effective

C.  

Greentree must offer a standard contract to Dr. Cortelyou, without regard to the outcome of the credentialing process

D.  

Greentree will abandon the credentialing process now that Dr. Cortelyou has agreed to participate in Greentree's network

Discussion 0
Question # 19

Historically most HMOs have been

Options:

A.  

Closed-access HMO

B.  

Closed-panel HMO

C.  

Open-access HMO

D.  

Open-panel HMO

Discussion 0
Question # 20

Which of the following job descriptions best match the job of a telephone triage staff member?

Options:

A.  

Check patient vitals, write prescriptions, administer drugs.

B.  

Greet patients at the door, collect insurance information, schedule appointments, collect payments.

C.  

Determine urgency of the condition, notify emergency department, schedule appointments, authorize referrals, provide self-care information.

D.  

None of the above.

Discussion 0
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