Free AHIP AHM-540 Exam Questions
Absolute Free AHM-540 Exam Practice for Comprehensive Preparation
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AHIP AHM-540 Exam Questions
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Provided By: AHIP
- Exam: Medical Management (AHM540)
- Certification: AHIP Certification
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Total Questions: 165
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Updated On: Jan 27, 2025
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Rated: 4.9 |
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Online Users: 330
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Question 1
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Benchmarking is a quality improvement strategy used by some health plans. With regard to
benchmarking, it is correct to say that
Answer: D
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Benchmarking is a quality improvement strategy used by some health plans. With regard to
benchmarking, it is correct to say that
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Question 2
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Helena Ray, a member of the Harbrace Health Plan, suffers from migraine headaches. To treatMs. Ray’s condition, her physician has prescribed Upzil, a medication that has Food and DrugAdministration (FDA) approval only for the treatment of depression. Upzil has not been tested forsafety or effectiveness in the treatment of migraine headache. Although Harbrace’s medical policyfor migraine headache does not include coverage of Upzil, Harbrace has agreed to provide extracontractualcoverage of Upzil for Ms. Ray.In this situation, the prescribing of Upzil for Ms. Ray’s headaches is an example of
Answer: C
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Helena Ray, a member of the Harbrace Health Plan, suffers from migraine headaches. To treatMs. Ray’s condition, her physician has prescribed Upzil, a medication that has Food and DrugAdministration (FDA) approval only for the treatment of depression. Upzil has not been tested forsafety or effectiveness in the treatment of migraine headache. Although Harbrace’s medical policyfor migraine headache does not include coverage of Upzil, Harbrace has agreed to provide extracontractualcoverage of Upzil for Ms. Ray.In this situation, the prescribing of Upzil for Ms. Ray’s headaches is an example of
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Question 3
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The following statement(s) can correctly be made about the scope of case management:1. Case management incorporates activities that may fall outside a health plan’s typicalresponsibilities, such as assessing a member’s financial situation2. Case management generally requires a less comprehensive and complex approach to a courseof care than does utilization review3. Case management is currently applicable only to medical conditions that require inpatienthospital care and are categorized as catastrophic in terms of health and/or costs
Answer: D
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The following statement(s) can correctly be made about the scope of case management:1. Case management incorporates activities that may fall outside a health plan’s typicalresponsibilities, such as assessing a member’s financial situation2. Case management generally requires a less comprehensive and complex approach to a courseof care than does utilization review3. Case management is currently applicable only to medical conditions that require inpatienthospital care and are categorized as catastrophic in terms of health and/or costs
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Question 4
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Examples of alternative healthcare practitioners are chiropractors, naturopaths, and
acupuncturists. The only well-established credentialing standards for alternative healthcare
practitioners are those available from NCQ
A. These NCQA credentialing standards apply to
Answer: A
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Examples of alternative healthcare practitioners are chiropractors, naturopaths, and
acupuncturists. The only well-established credentialing standards for alternative healthcare
practitioners are those available from NCQ
A. These NCQA credentialing standards apply to
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Question 5
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Health plans that offer healthcare programs for Medicare beneficiaries have a strong financial
incentive for identifying high-risk seniors as early as possible. The identification of high-risk seniors
is typically accomplished through the use of
Answer: C
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Health plans that offer healthcare programs for Medicare beneficiaries have a strong financial
incentive for identifying high-risk seniors as early as possible. The identification of high-risk seniors
is typically accomplished through the use of