Free AHIP AHM-540 Exam Questions

Question 1

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

A : All of the above

B : 1 and 2 only

C : 2 and 3 only

D : 1 only

Answer: B

Question 2

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

A : Mr. Farrell and his family

B : Mr. Farrell’s physician

C : Mr. Farrell’s health plan

D : All of the above

Answer: A

Question 3

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

Question 4