Free AHIP AHM-540 Exam Questions

Become AHIP Certified with updated AHM-540 exam questions and correct answers

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Total 165 Questions | Updated On: Nov 14, 2023

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Question 1

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 2

Comorbidity can have a significant impact on the effective implementation of disease management programs. Comorbidity can correctly be defined as the

A : degree to which the progression of a disease or condition is understood

B : prevalence or rate of a sickness or injury within a given population

C : degree of severity of a particular disease or condition

D : presence of a chronic condition or added complication other than the condition that requires medical treatment

Answer: D

Question 3

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

A : 1—2—3

B : 2—3—1

C : 3—1—2

D : 3—2—1

Answer: D

Question 4

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 5

One true statement about state regulation of case management activities is that the majority of states

A : have enacted laws that list specific quality management requirements for a case management program

B : consider case management files to be medical records that must be retained for a specified length of time

C : view case management similarly and follow similar patterns with their laws and regulations

D : have enacted laws or regulations requiring licensure or certification of case managers

Answer: B

Page: 1 / 33

Total 165 Questions | Updated On: Nov 14, 2023

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