AHIP AHM-250 Online Practice Questions and Exam Preparation

AHIP AHM-250 Online Questions & Answers

• Question 111:

  The Azure Group is a for-profit health plan that operates in the United States. The Fordham Group owns all of Azure's stock. The Fordham Group's sole business is the ownership of controlling interests in the shares of other companies. This information ind

  A. A holding company of the Fordham Group.
  B. A sister corporation of the Fordham Group.
  C. A subsidiary of the Fordham Group.
  D. All of the above.
  C. A subsidiary of the Fordham Group.

• Question 112:

  Brokers are one type of distribution channel that health plans use to market their health plans. One true statement about brokers for health plan products is that, typically, brokers

  A. Are not required to be licensed by the states in which they market health plans
  B. Are compensated on a salary basis
  C. Represent only one health plan or insurer
  D. Are considered to be an agent of the buyer rather than an agent of the health plan or Insurer
  D. Are considered to be an agent of the buyer rather than an agent of the health plan or Insurer

• Question 113:

  Which of the following is NOT a factor that is used by MCOs to determine which services will undergo utilization review?

  A. Cost per procedure
  B. Concurrent review
  C. Cost of review
  D. Access requirements
  D. Access requirements

• Question 114:

  Which of the following is CORRECT?

  A. Electronic transmittal of authorization is subject to the same regulatory requirements as other methods of transmittal
  B. Telephone transmittal increases data entry errors.
  C. Medical review is conducted before administrative review.
  D. Prospective review, concurrent review and retrospective review are types of utilization review
  D. Prospective review, concurrent review and retrospective review are types of utilization review

• Question 115:

  The scandent Health Group contracted with the Empire Corporation to provide behavioral healthcare services to.

  Empire employees. As a condition of providing behavioral healthcare services, scandent required Empire to contract with scandent for basic medical services scandent's actions constituted the type of antitrust violation known as a

  A. Horizontal group boycott
  B. Price-fixing agreement
  C. Horizontal division of markets
  D. Tying arrangement
  D. Tying arrangement

• Question 116:

  The Advantage Health Plan recently added the following features to its member services program:

  1.

  IVR

  2.

  Active member outreach program

  3.

  Advantage's member services staffing needs are likely to increase as a result of

  A. 1
  B. 2
  C. 1 and 2
  D. Neither 1 nor 2
  B. 2

• Question 117:

  One factor the Sandpiper Health Plan uses to assess its quality is a clinician's bedside manner, i.e., how friendly and understanding the clinician is, whether the patient feels that the clinician listens to the patient's concerns, how well the clinical

  A. a provider service quality issue
  B. an administrative service quality issue a healthcare process quality issue
  C. a healthcare outcomes quality issue
  D. a healthcare process quality issue
  A. a provider service quality issue

• Question 118:

  Phoebe Urich is covered by a traditional indemnity health insurance plan that specifies a $500 calendar-year deductible and includes a 20% coinsurance provision. When Ms. Urich was hospitalized, she incurred $3,000 in medical expenses that were covered by

  A. 1900
  B. 2000
  C. 2400
  D. 2500
  B. 2000

• Question 119:

  Federal Employee Health Benefits Program (FEHBP) requires health plans offering services to federal employees and their dependents to provide

  A. Immediate access to emergency services
  B. Urgent Appointments within 24 hours
  C. Routine appointments once a m
  D. D
  E. A
  F. B and C
  G. All of the listed options
  F. B and C

• Question 120:

  Some providers use electronic medical records (EMRs) to document their patients' care in an electronic form. The following statement(s) can correctly be made about EMRs:

  A. EMRs are computerized records of a patient's clinical, demographic, and administrator
  B. B only
  C. Both A and B
  D. Neither A nor B
  E. A only
  D. Neither A nor B