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AHIP AHM-250 Based on Real Exam Environment

Page: 10 / 14
Total 367 questions

Healthcare Management: An Introduction Questions and Answers

Question 37

The contract between the Honolulu MCO and Beverley Hills Hospital contains a 90 day cure provision. The Beverley Hills Hospital breached one of the contract requirements on July 31, 2004. The hospital remedied the problem by October 31, 2004. Which of the

Options:

A.

The contract would not be terminated as Beverley Hills hospital rectified the problem within 90 days.

B.

The contract would be terminated as Beverley Hills hospital was required to notify Honolulu MCO about the problem at least 90 days in advance.

C.

The contract would be terminated as Beverley Hills hospital was required to rectify the problem within 90 days.

D.

The contract would not be terminated as Beverley Hills hospital may escape adherence to the cure provision.

Question 38

Natalie Chan is a member of the Ultra Health Plan, a health plan. Whenever she needs nonemergency medical care, she sees Dr. David Craig, an internist. Ms. Chan cannot self-refer to a specialist, so she saw Dr. Craig when she experienced headaches. Dr. Cr

Options:

A.

Within Ultra's system, Ms. Chan received primary care from both Dr. Craig and Dr. Lee

B.

Ultra's system allows its members open access to all of Ultra's participating providers.

C.

Within Ultra's system, Dr. Craig serves as a coordinator of care or gatekeeper for the medical services that Ms. Chan receives.

D.

Ultra's network of providers includes Dr. Craig and Dr. Lee but not Arrow Hospital

Question 39

Wellborne HMO provides health-related information to its plan members through an Internet Web site. Laura Knight, a Wellborne plan member, visited Wellborne's Web site to gather uptodate information about the risks and benefits of various treatment option

Options:

A.

shared decision making

B.

self-care

C.

preventive care

D.

triage

Question 40

The National Association of Insurance Commissioners' (NAIC's) Unfair Claims Settlement Practices Act specifies standards for the investigation and handling of claims. The Act defines unfair claims practices and notes that such practices are improper if the

Options:

A.

Both A and B

B.

A only

C.

B only

D.

Neither A nor B

Page: 10 / 14
Total 367 questions