AHIP AHM-250 Online Practice Questions and Exam Preparation

AHIP AHM-250 Online Questions & Answers

• Question 231:

  Which of the following statements about Family and Medical Leave Act (FMLA) is WRONG?

  A. Employers need to maintain the coverage of group health insurance during this period
  B. Employees can take upto 12 weeks of unpaid leave in a 36 month period
  C. Protects people faced with birth/adoption or seriously ill family members
  D. Employers that have > 50 employees need to comply
  B. Employees can take upto 12 weeks of unpaid leave in a 36 month period

• Question 232:

  Allgood Medical, Inc., a health plan, has contracted with Mercy Memorial Hospital to provide inpatient medical services to Allgood's plan members. The terms of the contract specify that Allgood will reimburse Mercy Memorial on the basis of a negotiated ch

  A. per diem agreement
  B. fee-for-service agreement
  C. withhold agreement
  D. diagnostic related group (DRG) agreement
  A. per diem agreement

• Question 233:

  One true statement regarding ethics and laws is that the values of a community are reflected in

  A. both ethics and laws, and both ethics and laws are enforceable in the court system
  B. both ethics and laws, but only laws are enforceable in the court system
  C. ethics only, but only laws are enforceable in the court system
  D. laws only, but both ethics and laws are enforceable in the court system
  B. both ethics and laws, but only laws are enforceable in the court system

• Question 234:

  John Kerry's employer has contracted to receive healthcare for its employees from the Democratic Healthcare System. Mr. Kerry visits his PCP, who sends him to have some blood tests. The PCP then refers Mr. Kerry to a specialist who hospitalizes him for on

  A. a physician practice organization
  B. a physician-hospital organization
  C. a management services organization
  D. an integrated delivery system
  D. an integrated delivery system

• Question 235:

  Bill Clinton is a member of Lewinsky's PBM plan which has a three-tier copayment structure. Bill fell ill and his doctor prescribed him AAA, a brand-name drug which was included in the Lewinsky's formulary; BBB, a non-formulary drug; and CCC, a generic dr

  A. CCC, AAA, BBB
  B. BBB, CCC, AAA
  C. BBB, AAA, CCC
  D. CCC, BBB, AAA
  A. CCC, AAA, BBB

• Question 236:

  Health plans require utilization review for all services administered by its participating physicians.

  A. True
  B. False
  B. False

• Question 237:

  The following statements apply to health reimbursement arrangements. Select the answer choice that contains the correct statement.

  A. Only employers are permitted to establish and fund HRAs.
  B. The popularity of HRAs waned following a 2002 ruling by U.S. Treasury Department regarding their treatment in the tax code.
  C. HRAs must be offered in conjunction with a high-deductible health plan.
  D. The guaranteed portability feature of HRAs has contributed to their popularity.
  A. Only employers are permitted to establish and fund HRAs.

• Question 238:

  The Madison Health Plan, a national MCO, and a local hospital system that operates its own managed healthcare network recently created a new and separate managed healthcare organization, the Pineapple Health Plan. Madison and the hospital system share own

  A. a consolidation
  B. a joint venture
  C. a merger
  D. an acquisition
  B. a joint venture

• Question 239:

  The following statements are about the underwriting function within a health plan. Select the answer choice containing the correct statement.

  A. The underwriting function in a health plan is primarily concerned with ensuring that the group being underwritten does not include any individuals who are likely to have higher than average utilization of medical services.
  B. Compared to a health plan with relaxed underwriting requirements, a similar health plan with very strict underwriting requirements can expect to experience increased healthcare costs and to have significantly higher plan enrollment.
  C. Typically, a health plan guarantees the premium rate for a group health contract for a period of no more than six months.
  D. In order to determine the actual premium to charge a group, a group underwriter typically considers such factors as level of participation, benefits, and the age and gender distribution of group members.
  D. In order to determine the actual premium to charge a group, a group underwriter typically considers such factors as level of participation, benefits, and the age and gender distribution of group members.

• Question 240:

  Health plans often carve out specialty services that have one or more of the following characteristics

  A. A poorly defined patient population
  B. High or increasing costs
  C. Appropriate utilization
  D. All the above
  B. High or increasing costs