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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

As a follow-up to a performance improvement plan for member services, the Stellar Health Plan conducted an evaluation of the success of the plan. Stellar conducted its evaluation as the plan was being carried out. The evaluation focused on specific activities and assessed the relative importance of those activities to the plan as a whole. This information indicates that Stellar’s evaluation of the plan was both

Options:

A.

concurrent and formative

B.

concurrent and summative

C.

retrospective and formative

D.

retrospective and summative

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Question 2

To see that utilization guidelines are consistently applied, UR programs rely on authorization systems. Determine whether the following statement about authorization systems is true or false:

Only physicians can make nonauthorization decisions based on medical necessity.

Options:

A.

True

B.

False

Question 3

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

Options:

A.

case management

B.

geriatric evaluation and management (GEM)

C.

intervention identification

D.

interdisciplinary home care (IHC)