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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 characteristic of the workers' compensation program is that:

Options:

A.

workers' compensation coverage is available to all employees, regardless of their eligibility for health insurance coverage

B.

indemnity benefits currently account for less than 10% of all workers' compensation benefits

C.

workers' compensation programs in most states require eligible employees to obtain medical treatment only from members of a provider network

D.

workers' compensation programs include deductibles and coinsurance requirements

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Question 2

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

Question 3

The Portway Hospital is qualified to receive Medicaid subsidy payments as a disproportionate share hospital (DHS). The DHS payments that Portway receives are

Options:

A.

Made for services rendered to specific patients

B.

Made with matching state and federal funds

C.

Included in the Medicaid capitation payment made to patients’ health plans

D.

Defined as cost-based reimbursement (CBR) equal to 100% of Portway’s reasonable costs of providing services to Medicaid recipients

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