AHIP AHM-250 Online Practice Questions and Exam Preparation

AHIP AHM-250 Online Questions & Answers

• Question 361:

  Which is an advantage of a for-profit health plan?

  A. Flexibility in raising capital
  B. Double taxation
  C. Exemption from paying federal income taxes.
  D. None of the above.
  A. Flexibility in raising capital

• Question 362:

  The following statements are about standards set forth in the Quality Improvement System for Managed Care (QISMC), established by the Health Care Financing Administration (HCFA, now known as the Centers for Medicare and Medicaid Services).

  A. As a result of the Balanced Budget Refinement Act (BBRA), PPOs are required to meet all QISMC quality requirements.
  B. QISMC standards typically do not apply to such Medicare services as mental health or substance abuse services.
  C. Medicaid primary care case manager (PCCM) programs are subject to the same QISMC quality standards and performance measures as are all other Medicare and Medicaid programs.
  D. QISMC standards and guidelines are required for Medicare MCOs, but they are applicable to Medicaid MCOs at the discretion of the individual states.
  D. QISMC standards and guidelines are required for Medicare MCOs, but they are applicable to Medicaid MCOs at the discretion of the individual states.

• Question 363:

  In order to be more effective, changes to structure and processes must be carefully

  A. Planned
  B. Implemented
  C. Documented
  D. Evaluated
  E. All the above
  E. All the above

• Question 364:

  The statements below describe technology used by two MCOs to respond to incoming telephone calls:

  The Morton MCO uses an automated system that answers telephone calls with recorded or synthesized speech and prompts the caller to respond to a menu of option

  A. Autumn's device is best described as an interactive voice response (IVR) system.
  B. Both Morton's system and Autumn's device are applications of computer/telephony integration (CTI).
  C. Morton's system is best described as an automatic call distributor (ACD).
  D. Morton's system can be correctly characterized as an expert system.
  B. Both Morton's system and Autumn's device are applications of computer/telephony integration (CTI).

• Question 365:

  The Granite Health Plan is a coordinated care plan (CCP) that participates in the Medicare+Choice program. This information indicates that Granite

  A. must comply with all state-mandated benefits and provider requirements
  B. must offer each of its enrollees a Medicare supplement
  C. places primary care t the censer of the delivery system and focuses on managing patient care at all levels
  D. most likely must cover Medicare Part A, but not Medicare Part B, benefits
  C. places primary care t the censer of the delivery system and focuses on managing patient care at all levels

• Question 366:

  One type of physician-only integration model is a consolidated medical group. Typical characteristics of a consolidated medical group include A. that it may be a single-specialty or multi-specialty practice

  B. operates in one or a few facilities rather than in many independent offices
  C. achieves economies of scale in the group's integrated operations
  D. all of the above
  D. all of the above

• Question 367:

  Khalyn Drury's employer includes managed dental care in its employee benefits package. During open enrollment, Ms. Drury enrolled in the dental plan, which provides dental services to its members in exchange for a prepayment (the premium). Dental services

  A. dental preferred provider organization (PPO)
  B. traditional fee-for-service (FFS) dental plan
  C. plan with a dental point of service (POS) option
  D. dental health maintenance organization (DHMO)
  D. dental health maintenance organization (DHMO)