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AHM-540 Exam Dumps : Medical Management

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Medical Management Questions and Answers

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Question 1

The following statements are about medical management considerations for dental care. Select the answer choice containing the correct statement.

Options:

A.

Managed dental care organizations are regulated at the state rather than the federal level.

B.

Dental care differs from medical care in that most dental care is provided by specialists.

C.

Dental preferred provider organizations (Dental PPOs) are subject to more regulation than are dental health maintenance organizations (DHMOs).

D.

Managed dental plans are accredited by the National Association of Dental Plans (NADP).

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Question 2

The nature of behavioral healthcare creates unique medical management challenges for health plans. One method health plans have used to support the delivery of appropriate services in a cost-effective manner is to

Options:

A.

remove behavioral healthcare services from the primary care setting

B.

shift behavioral healthcare from acute inpatient settings to alternative settings when feasible

C.

reserve the use of psychotherapy for treatment of those conditions that persist over long periods of time or for the life of the patient

D.

offer the same level of compensation to all of the professional disciplines that provide behavioral healthcare services to plan members

Question 3

With respect to the activities of MCO medical directors, it is correct to say that medical directors typically perform all of the following activities EXCEPT

Options:

A.

maintaining clinical practices

B.

delivering performance feedback to providers

C.

participating in utilization management (UM) activities

D.

educating other MCO staff about new clinical developments or provider innovations that might impact clinical practice management

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