Free AHIP AHM-540 Exam Questions

The paragraph below contains two pairs of terms in parentheses. Determine which term in eachpair correctly completes the paragraph. Then select the answer choice containing the two termsthat you have chosen.Health plans use both internal and external standards to assess the quality of the services thatthey provide. (Internal / External) standards are based on information such as published industrywideaverages or best practices of recognized industry leaders. Health plans primarily rely on(internal / external) standards to evaluate healthcare services. 

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

A health plan’s coverage policies are linked to its purchaser contracts. The following statement(s) can correctly be made about the purchaser contract and coverage decisions: 1. In case of conflict between the purchaser contract and a health plan’s medical policy or benefits administration policy, the contract takes precedence 2. Purchaser contracts commonly exclude custodial care from their coverage of services and supplies 3. All of the criteria for coverage decisions must be included in the purchaser contract  

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

Increased demands for performance information have resulted in the development of various health plan report cards. With respect to most of the report cards currently available, it is correct to say