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AHM-540 Exam Dumps : Medical Management

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Medical Management Questions and Answers

Question 1

The paragraph below contains an incomplete statement. Select the answer choice containing the term that correctly completes the paragraph.

Each quality standard used by a health plan is associated with quality indicators. A ______________ indicator is a form of aggregate data indicator that produces results that fit within a specified range, such as the length of time to schedule an appointment.

Options:

A.

yes/no

B.

sentinel event

C.

discrete variable

D.

continuous variable

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Question 2

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

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