AHIP AHM-250 Online Practice Questions and Exam Preparation

AHIP AHM-250 Online Questions & Answers

• Question 351:

  Merle Spencer has coverage under both Medicare Part A and Medicare Part B. Ms. Spencer recently was hospitalized for chest pains, and she incurred charges for:

  The cost of hospitalization for two days Diagnostic tests performed in the hospital Trans

  A. ambulance and the diagnostic tests
  B. ambulance, the diagnostic tests, and the physician's professional services
  C. cost of hospitalization
  D. cost of hospitalization and the physician's professional services
  D. cost of hospitalization and the physician's professional services

• Question 352:

  Which of the following best describes an organization that is owned by a hospital or group of investors and provides management and administrative support services to individual physicians or small group practices?

  A. Independent Practice Association (IPA).
  B. Group Practice Without Walls (GPWW)
  C. Management Services Organization (MSO).
  D. Consolidated Medical Group.
  C. Management Services Organization (MSO).

• Question 353:

  Which of the following statements about the Title VII of the Civil Rights Act is WRONG?

  A. Employers with more than 15 employees engaged in interstate commerce need to comply
  B. Pregnancy Discrimination Act (an amendment to this act) requires health plans to provide coverage during childbirth and related medical conditions on the same basis as they provide coverage for other medical conditions
  C. Allows HMOs to set different policies for people from different races, religions, sex or national origin to safeguard their interests.
  D. Protects all employees
  C. Allows HMOs to set different policies for people from different races, religions, sex or national origin to safeguard their interests.

• Question 354:

  In order to compensate for lost revenue resulting from services provided free or at a significantly reduced cost to other patients, many healthcare providers spread these unreimbursed costs to paying patients or third-party payors. This practice is known

  A. dual choice
  B. cost shifting
  C. accreditation
  D. defensive medicine
  B. cost shifting

• Question 355:

  Immediate evaluation and treatment of illness or injury can be provided in any of the following care settings:

  A. A, B, C
  B. A, C, B
  C. B, C, A
  D. C, A, B
  B. A, C, B

• Question 356:

  Arthur Moyer is covered under his employer's group health plan, which must comply with the Consolidated Omnibus Budget Reconciliation Act (COBRA). Mr. Moyer is terminating his employment. He has elected to continue his coverage under his employer's group

  A. 18 months, but his coverage under COBRA will cease if he obtains group health coverage through another employer.
  B. 18 months, even if he obtains group health coverage through another employer.
  C. 36 months, but his coverage under COBRA will cease if he obtains group health coverage through another employer.
  D. 36 months, even if he obtains group health coverage through another employer.
  A. 18 months, but his coverage under COBRA will cease if he obtains group health coverage through another employer.

• Question 357:

  To achieve widespread use of electronic data interchange (EDI) in the healthcare industry, all entities within the industry need to agree on industry standards regarding the information format and software to be used. Several organizations are making cont

  A. Computer-based Patient Records Institute (CPRI)
  B. American National Standards Institute (ANSI)
  C. American Health Information Management Association (AHIMA)
  D. American Medical Association (AMA)
  B. American National Standards Institute (ANSI)

• Question 358:

  Appropriateness of treatment provided is determined by developing criteria that if unmet will prompt further investigation of a claim which are also called:

  A. Codes
  B. Lists
  C. Edits
  D. Checks
  C. Edits

• Question 359:

  Dr. Samuel Aldridge's provider contract with the Badger Health Plan includes a typical due process clause. The primary purpose of this clause is to:

  A. State that Dr. Aldridge's provider contract with Badger will automatically terminate if he loses his medical license or hospital privileges.
  B. Specify a time period during which the party that breaches the provider contract must remedy the problem in order to avoid termination of the contract.
  C. Give Dr. Aldridge the right to appeal Badger's decision if he is terminated with cause from Badger's provider network.
  D. Specify that Badger can terminate this provider contract without providing a reason, but only if Badger gives Dr. Aldridge at least 90-days' notice of its intent to terminate the contract.
  C. Give Dr. Aldridge the right to appeal Badger's decision if he is terminated with cause from Badger's provider network.

• Question 360:

  One true statement about community rating, a rating method commonly used by health plans, is that:

  A. It requires a health plan to set premiums for financing medical care according to the health plan's expected cost of providing medical benefits to a sub-group within the community.
  B. A health plan usually uses community rating to set premiums for large groups.
  C. It tends to lead to greater fluctuations in premium rates than do other rating methods.
  D. A health plan seldom uses community rating to set premiums for large groups.
  D. A health plan seldom uses community rating to set premiums for large groups.