AHIP AHIP Certification AHM-250 Questions & Answers

• Question 41:

  Prescription drug benefits in Medicare can be obtained through:

  A. Stand alone prescription drug pl (PDPs)

  B. Traditional fee for service (FFS) Medicare

  C. Medicare Advantage pl

  D. Both A and C

  Correct Answer: A

• Question 42:

  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

  Correct Answer: C

• Question 43:

  The Meadowcreek Group is an organization comprised of individual physicians and physicians in small group practices. Meadowcreek enters into contracts with health plans, and then Meadowcreek contracts separately with its physician members. In situations with

  A. a group practice without walls (GPWW)

  B. a messenger model

  C. an individual practice association (IPA)

  D. a Physician Practice Management (PPM) company

  Correct Answer: C

• Question 44:

  The participating physicians remain independent practitioners who operate out of their own offices and can treat other patients in addition to Kayak plan members. Kayak can correctly be characterized as

  A. a closed-panel HMO

  B. an open-panel HMO

  C. a direct contract model HMO

  D. a dual choice HMO

  Correct Answer: B

• Question 45:

  Which of the following is NOT a preventive care initiative often used by health plans?

  A. Screening for high blood pressure

  B. Maternity management programs

  C. Vaccines

  D. Physical therapy

  Correct Answer: D

• Question 46:

  FSA is funded by

  A. Employers

  B. Employee

  C. A and B

  Correct Answer: AB

• Question 47:

  The Hill Health Plan designed a set of benefits that it packaged in the form of a PPO product. Hill then established a pricing structure that allowed its product to compete in the small group market, and it developed advertising designed to inform potential

  A. $140

  B. $170

  C. $180

  D. $210

  Correct Answer: B

• Question 48:

  The parties to the contractual relationship that provides Castle's group health coverage to Knoll employees are

  A. Castle and Knoll only

  B. Knoll and all covered Knoll employees only

  C. Castle, Knoll, and all covered Knoll employees

  D. Castle and all covered Knoll employees only

  Correct Answer: A

• Question 49:

  The following statement(s) can correctly be made about the characteristics of reports that should be provided to managers for use in managing a healthcare delivery system:

  A. Users typically need access to all the raw data used to generate reports

  B. Info

  C. Both A and B

  D. A only

  E. B only

  F. Neither A nor B

  Correct Answer: D

• Question 50:

  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)

  Correct Answer: B