AHM-250 Practice Questions

A.  

Users typically need access to all the raw data used to generate reports

B.  

Info

C.  

Both A and B

D.  

A only

E.  

B only

F.  

Neither A nor B

A.  

$60

B.  

$80

C.  

$120

D.  

$160

A.  

A statement of the HMO’s goals and objectives for evaluating and improving enrollees’ health status

B.  

Documentation of all quality assurance activities

C.  

System for periodically reporting program results to the HMO’s board of directors, its providers, and regulators

D.  

All the above

A.  

In order to promote a product to the individual market, MCOs typically rely on personal selling by captive agents rather than on promotional tools such as direct mail, telemarketing, and advertising.

B.  

Managed Medicare plans typically are allowed to reject a Medicare applicant on the basis of the results of medical underwriting of the applicant.

C.  

HCFA (now known as the Centers for Medicare and Medicaid Services) must approve all membership and enrollment materials used by MCOs to market managed care products to the Medicare population.

D.  

Managed care plans are not allowed to health screen individual market customers who are under age 65, even if the health screen could help prevent anti selection.

A.  

Lack of Freedom of choice

B.  

Absence of Primary care physician

C.  

Cost-cutting efforts and the structure of coverage

D.  

All of the above

A.  

$80

B.  

$120

C.  

$160

D.  

$240

A.  

Individuals aged 65 & above, regardless of income & medical history

B.  

Individuals suffering from end stage renal disease, regardless of age

C.  

Individuals aged 50 or above suffering from qualifying disabilities

D.  

Both A & B

A.  

both Mr. Lee and Mr. Beeker

B.  

Mr. Lee only

C.  

Mr. Beeker only

D.  

neither Mr. Lee nor Mr. Beeker

A.  

Both A and B

B.  

A only

C.  

B only

D.  

Neither A nor B

A.  

A declining economy can lead to lower healthcare costs as a result of an older population with greater healthcare needs.

B.  

A larger patient population increases pressure on the health plan to offer larger panels.

C.  

Provider networks are not affected by the federal and state laws that apply to health plans

D.  

Network management standards established by independent accrediting organizations have no influence on health plan network design.