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AHIP AHM-540 Exam With Confidence Using Practice Dumps

Exam Code:
AHM-540
Exam Name:
Medical Management
Certification:
Vendor:
Questions:
163
Last Updated:
Mar 9, 2025
Exam Status:
Stable
AHIP AHM-540

AHM-540: AHIP Certification Exam 2025 Study Guide Pdf and Test Engine

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Medical Management Questions and Answers

Question 1

This agency’s accreditation decisions are based on the results of an on-site survey of clinical and administrative systems and processes, as well as the health plan’s performance on selected effectiveness of care and member satisfaction measures.

Options:

A.

American Accreditation HealthCare Commission/URAC (URAC)

B.

Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

C.

Community Health Accreditation Program (CHAP)

D.

National Committee for Quality Assurance (NCQA)

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Question 2

The case management program director at the Nova Health Plan calculated the program’s ratio of medical expense savings to case management administrative costs for the previous quarter based on the following cost information:

Administrative costs for case management ..........$40,000

Actual medical care expenses for patients under case management ..........$680,000

Projected medical care expenses for the same patients without case management ..........$900,000

This information indicates that, for the previous quarter, Nova’s ratio of medical expense savings to case management administrative costs was

Options:

A.

0.71/1

B.

0.80/1

C.

5.50/1

D.

1.25/1

Question 3

Comorbidity can have a significant impact on the effective implementation of disease management programs. Comorbidity can correctly be defined as the

Options:

A.

degree to which the progression of a disease or condition is understood

B.

prevalence or rate of a sickness or injury within a given population

C.

degree of severity of a particular disease or condition

D.

presence of a chronic condition or added complication other than the condition that requires medical treatment