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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:
Dec 21, 2024
Exam Status:
Stable
AHIP AHM-540

AHM-540: AHIP Certification Exam 2024 Study Guide Pdf and Test Engine

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Medical Management Questions and Answers

Question 1

PBMs are accredited by the same organizations that accredit health plans.

Options:

A.

True

B.

False

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Question 2

The paragraph below contains two pairs of terms in parentheses. Determine which term in each pair correctly completes the paragraph. Then select the answer choice containing the two terms that you have chosen.

Health plans use both internal and external standards to assess the quality of the services that they provide. (Internal / External) standards are based on information such as published industry-wide averages or best practices of recognized industry leaders. Health plans primarily rely on (internal / external) standards to evaluate healthcare services.

Options:

A.

Internal / internal

B.

Internal / external

C.

External / internal

D.

External / external

Question 3

Michelle Durden, who is enrolled in a dental health maintenance organizations (DHMO) offered by her employer, is due for a routine dental examination. If the plan is typical of most DHMOs, then Ms. Durden

Options:

A.

must pay the entire cost of the examination

B.

must obtain a referral to a dentist from her primary care provider (PCP)

C.

can schedule the examination without preauthorization of payment by the DHMO

D.

can schedule an unlimited number of examinations and cleanings per year