Free AHIP AHM-540 Exam Questions

Question 1

Health plans that offer healthcare programs for Medicare beneficiaries have a strong financial incentive for identifying high-risk seniors as early as possible. The identification of high-risk seniors is typically accomplished through the use of

A : case management

B : geriatric evaluation and management (GEM)

C : intervention identification

D : interdisciplinary home care (IHC)

Answer: C

Question 2

Health plans that offer healthcare programs for Medicare beneficiaries have a strong financial incentive for identifying high-risk seniors as early as possible. The identification of high-risk seniors is typically accomplished through the use of

A : case management

B : geriatric evaluation and management (GEM)

C : intervention identification

D : interdisciplinary home care (IHC)

Answer: C

Question 3

Medicare beneficiaries can obtain healthcare benefits through fee-for-service (FFS) Medicare programs, Medicare medical savings account (MSA) plans, Medigap insurance, or coordinated care plans (CCPs). Unlike other coverage options, CCPs

A : provide only those benefits covered by Medicare Part A and Part B

B : are not subject to federal or state regulation

C : place primary care at the center of the delivery system

D : are structured as indemnity plans

Answer: C

Question 4

Medicare beneficiaries can obtain healthcare benefits through fee-for-service (FFS) Medicare programs, Medicare medical savings account (MSA) plans, Medigap insurance, or coordinated care plans (CCPs). Unlike other coverage options, CCPs

A : provide only those benefits covered by Medicare Part A and Part B

B : are not subject to federal or state regulation

C : place primary care at the center of the delivery system

D : are structured as indemnity plans

Answer: C

Question 5

Benchmarking is a quality improvement strategy used by some health plans. With regard to benchmarking, it is correct to say that

A : cost-based benchmarking reveals why some areas of a health plan perform better or worse than comparable areas of other organizations

B : diagnosis-related groups (DRGs) are a source of benchmarking data that describe individual procedures and cover both inpatient and outpatient care

C : patient billing records provide a much more accurate account of procedure costs for benchmarking than do current procedural terminology (CPT) codes

D : the focus of benchmarking for health plan has shifted from identifying the lowest cost practices to identifying best practices

Answer: D