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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 # 31

The existing committees at the Majestic Health Plan, a health plan that is subject to the requirements of HIPAA, include the Executive Committee and the Corporate Compliance Committee. The Executive Committee serves as a long-term advisory body on issues related to overall organizational policy. The Corporate Compliance Committee are convened to address specific management concerns. The following statement(s) can correctly be made about these committees:

Options:

A.  

Majestic's Executive Committee is an example of a Specific committee.

B.  

The Corporate Compliance Committee is an Example of an Adhoc company.

C.  

A & B

Discussion 0
Question # 32

Which of the following statements about Family and Medical Leave Act (FMLA) is WRONG?

Options:

A.  

Employers need to maintain the coverage of group health insurance during this period

B.  

Employees can take upto 12 weeks of unpaid leave in a 36 month period

C.  

Protects people faced with birth/adoption or seriously ill family members

D.  

Employers that have > 50 employees need to comply

Discussion 0
Question # 33

The Mirror Health Plan uses a form of computer/telephony integration (CTI) to manage telephone calls coming into its member services department. When a member calls the plan's central telephone number, a device answers the call with a recorded message and

Options:

A.  

a member outreach program

B.  

a complaint resolution procedure (CRP)

C.  

an automatic call distributor (ACD)

D.  

an interactive voice response (IVR) system

Discussion 0
Question # 34

Medigap policies were standardized into ten standard benefit pl ranging from A-J by the ____

Options:

A.  

Omnibus Budget Reconciliation Act (OBRA) of 1990

B.  

Tax Equity & Fiscal Responsibility Act (TEFRA) of 1982

C.  

Medicare Modernization Act (MMA) of 2003

D.  

Balanced Budget Act (BBA) of 1997

Discussion 0
Question # 35

Which of the following statements is NOT a requirement for a service to be deemed a 'medically necessary service'?

Options:

A.  

Furnished in the least intensive type of medical care setting required by the member's condition.

B.  

Solely for the convenience of the member.

C.  

In accordance with the standards of good medical practice.

D.  

Consistent with the symptoms of the member's condition.

Discussion 0
Question # 36

Which of the following statements about EPO & HMO models is FALSE?

Options:

A.  

In-network visit is allowed only on PCP's referral in HMO model.

B.  

Out-of-network visit is not allowed in HMO model.

C.  

Out-of-network visit is not allowed in EPO model.

D.  

In-network visit is allowed only on PCP's referral in EPO model.

Discussion 0
Question # 37

Advantages of EDI over manual data management systems

Options:

A.  

Speed of data refer

B.  

Loss of data integrity

C.  

All of the above

D.  

None of the above

Discussion 0
Question # 38

The health plan determines what it considers to be the acceptable fee for a service or procedure and the physician agrees to accept that amount as payment in full for the procedure

Options:

A.  

Usual, Customary, and Reasonable fee

B.  

Discounted FFS

C.  

Fee Maximum

D.  

Relative Value Scale

Discussion 0
Question # 39

Medicare Advantage product options include:

Options:

A.  

Coordinated care plans, medical savings accounts and national PPOs.

B.  

Private Fee for Service plans, health care prepayment plans and medical savings accounts

C.  

Coordinated care plans, regional PPOs and private fee for service plans

D.  

Cost contracts, coordinated care programs and medical savings accounts.

Discussion 0
Question # 40

The following statement can be correctly made about Medicare Advantage eligibility:

Options:

A.  

Individuals enrolled in a MA plan must enroll in a stand-alone Part D prescription drug plan.

B.  

Individuals enrolled in a MA plan do not have to be eligible for Medicare Part A

C.  

Individuals enrolled in an MSA plan or a PFFS plan without Medicare drug coverage can enroll in Medicare Part

D.  

D.  

Individuals can enroll in MA plan in multiple regions.

Discussion 0
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