Free AHIP AHM-540 Exam Questions

The following statement(s) can correctly be made about the scope of case management:1. Case management incorporates activities that may fall outside a health plan’s typicalresponsibilities, such as assessing a member’s financial situation2. Case management generally requires a less comprehensive and complex approach to a courseof care than does utilization review3. Case management is currently applicable only to medical conditions that require inpatienthospital care and are categorized as catastrophic in terms of health and/or costs 

Demetrius Farrell, age 82, is suffering from a terminal illness and has consulted his health planabout the care options available to him. In order to avoid unwanted, futile interventions, Mr. Farrellsigned an advance directive that indicates the types of end-of-life medical treatment he wants toreceive. His family is to use this document as a guide should Mr. Farrell become incapacitated.For this question, if answer choices (A) through (C) are all correct, select answer choice (D).Otherwise, select the one correct answer choice.Decisions regarding Mr. Farrell’s end-of-life care are legally the right and responsibility of 

Health plans arrange for the delivery of various levels of healthcare, including1. Emergency care2. Urgent care3. Primary care delivered in a provider’s officeIn a ranking of these levels of care according to cost, beginning with the least expensive level ofcare and ending with the most expensive level of care, the correct order would be 

Michelle Durden, who is enrolled in a dental health maintenance organizations (DHMO) offered by her employer, is due for a routine dental examination. If the plan is typical of most DHMOs, then Ms. Durden

Health plans that choose to contract with external organizations for pharmacy services typicallycontract with pharmacy benefit managers (PBMs). Functions that a PBM typically performs for ahealth plan include1. Managing the costs of prescription drugs2. Promoting efficient and safe drug use3. Determining the health plan’s internal management responsibilities for pharmacy services