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AHM-530 Exam Dumps : Network Management

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Network Management Questions and Answers

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Question 1

One reason that an health plan would want to use the actual acquisition cost (AAC) pricing system to calculate its drug costs is that, of the systems commonly used to calculate drug costs, the AAC system

Options:

A.

Provides the lowest level of cost for the health plan

B.

Most closely represents what pharmacies are actually charged for prescription drugs

C.

Offers the best control over multiple-source pharmaceutical products

D.

Is the least expensive pricing system for the health plan to implement

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Question 2

Although a health plan is allowed to delegate many activities to outside sources, the National Committee for Quality Assurance (NCQA) has determined that some activities are not delegable.

These activities include

Options:

A.

evaluation of new medical technologies

B.

overseeing delegated medical records activities

C.

developing written statements of members’ rights and responsibilities

D.

all of the above

Question 3

The actual number of providers included in a provider network may be based on staffing ratios. Staffing ratios relate the number of

Options:

A.

Potential providers in a plan’s network to the number of individuals in the area to be served by the plan

B.

Providers in a plan’s network to the number of enrollees in the plan

C.

Providers outside a plan’s network to the number of providers in the plan’s network

D.

Support staff in a plan’s network to the number of medical practitioners in the plan’s network

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