AHIP AHM-250 Online Practice Questions and Exam Preparation

AHIP AHM-250 Online Questions & Answers

• Question 241:

  Select the correct statement regarding TRICARE Extra plan options to military personnel's.

  A. Out of pocket expenses are generally high in tricare extra than TRICARE standard
  B. Enrollment is not necessary to participate in TRICARE Extra
  C. TRICARE Extra provides coordinated care managed by primary care case manager
  C. TRICARE Extra provides coordinated care managed by primary care case manager

• Question 242:

  A common physician-only integrated model is a group practice without walls (GPWW). One characteristic of a typical GPWW is that the

  A. GPWW combines multiple independent physician practices under one umbrella organization
  B. GPWW generally has a lesser degree of integration than does an IPA
  C. member physicians cannot own the GPWW
  D. GPWW's member physicians must perform their own business operations
  A. GPWW combines multiple independent physician practices under one umbrella organization

• Question 243:

  The administrative simplification standards described under Title II of HIPAA include privacy standards to control the use and disclosure of health information. In general, these privacy standards prohibit

  A. all health plans, healthcare providers, and healthcare clearinghouses from using any protected health information for purposes of treatment, payment, or healthcare operations without an individual's written consent
  B. patients from requesting that restrictions be placed on the accessibility and use of protected health information
  C. transmission of individually identifiable health information for purposes other than treatment, payment, or healthcare operations without the individual's written authorization
  D. patients from accessing their medical records and requesting the amendment of incorrect or incomplete information
  D. patients from accessing their medical records and requesting the amendment of incorrect or incomplete information

• Question 244:

  Col. Martin Avery, on active duty in the U.S. Army, iseligibleto receive healthcare benefits under one of the three TRICARE health plan options. If Col Avery elects to participate in TRICARE Prime, he will be

  A. able to obtain full benefits for services obtained from network and non-network providers
  B. subject to copayment, deductible, and coinsurance requirements for any medical care he receives
  C. required to formally enroll for coverage and pay an enrollment fee
  D. assigned to a primary care manager who is responsible for coordinating all his care
  D. assigned to a primary care manager who is responsible for coordinating all his care

• Question 245:

  Common characteristics of POS products are

  A. Lack of Freedom of choice
  B. Absence of Primary care physician
  C. Cost-cutting efforts and the structure of coverage
  D. All of the above
  C. Cost-cutting efforts and the structure of coverage

• Question 246:

  The Acme HMO recruits and contracts directly with a wide range of physicians--both PCPs and specialists--in its geographic area on a non-exclusive basis. There is no separate legal entity that represents and negotiates the contracts for the physicians. The

  A. an independent practice association (IPA) model HMO
  B. a staff model HMO
  C. a direct contract model HMO
  D. a group model HMO
  C. a direct contract model HMO

• Question 247:

  The following statements are about the various Health Plan Accountability Models adopted by the NAIC.

  A. Under the terms of the Health Plan Network Adequacy Model Act, all health plans would be required to hold covered persons harmless against provider collections and provide continued coverage for uncompleted treatment in the event of plan insolvency
  B. The Health Carrier Grievance Procedure Model Act requires all health carriers to maintain a first-level grievance review, but it does not require any second-level review
  C. According to the Health Care Professional Credentialing Verification Model Act, a health plan must select all providers who meet the plan's credentialing criteria
  D. The Quality Assessment and Improvement Model Act exempts closed plans from implementing a quality improvement program.
  A. Under the terms of the Health Plan Network Adequacy Model Act, all health plans would be required to hold covered persons harmless against provider collections and provide continued coverage for uncompleted treatment in the event of plan insolvency

• Question 248:

  The following statements apply to enrollment statistics for HSAs. Select the answer choice that contains the CORRECT statement.

  A. HSAs have helped expand health care coverage to consumers who were previously uninsured.
  B. The vast majority of enrollees in HSA health plans are wealthy.
  C. Most people receiving coverage through HSA health plans are individuals rather than families.
  D. HSAs appeal primarily to young consumers.
  A. HSAs have helped expand health care coverage to consumers who were previously uninsured.

• Question 249:

  The Koster Company plans to purchase a health plan for its employees from Intuitive HMO. Intuitive will administer the plan and will bear the responsibility of guaranteeing claim payments by paying all incurred covered benefits. Koster will pay for the he

  A. fully funded plan
  B. stop-loss plan
  C. self-pay plan
  D. self-funded plan
  A. fully funded plan

• Question 250:

  Consumer-directed health plans are not a new concept. They actually got their start in the late 1970s with the advent of:

  A. Health savings accounts (HSAs)
  B. Health reimbursement arrangements (HRAs)
  C. Medical savings accounts (MSAs)
  D. Flexible spending arrangements (FSAs)
  D. Flexible spending arrangements (FSAs)