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AHIP AHM-250 Dumps Questions Answers

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Healthcare Management: An Introduction

Last Update Nov 23, 2024
Total Questions : 367

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Last Update Nov 23, 2024
Total Questions : 367

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Healthcare Management: An Introduction Questions and Answers

Questions 1

Members who qualify to participate in a health plan's case management program are typically assigned a case manager. During the course of the member's treatment, the case manager is responsible for

Options:

A.

Coordinating and monitoring the member's care

B.

Approve

C.

Both A and B

D.

A only

E.

B only

F.

Neither A nor B

Questions 2

Marlee Whitcomb was covered as a dependent under the group health plan provided by her father's employer. That health plan complied with the provisions of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1986. When Ms. Whitcomb married, she c

Options:

A.

can continue her group coverage for a period not to exceed 48 months

B.

can continue her group coverage for a period not to exceed 36 months

C.

cannot continue her group coverage, but has the right to convert the group coverage to an individual health plan

D.

can continue her group coverage indefinitely

Questions 3

Pharmacy benefit management (PBM) companies typically interact with physicians and pharmacists by performing such clinical services as physician profiling. Physician profiling from a PBM's point of view involves

Options:

A.

ascertaining that physicians in the plan have the necessary and appropriate credentials to prescribe medications

B.

compiling data on physician prescribing patterns and comparing physicians' actual prescribing patterns to expected patterns within select drug categories

C.

monitoring patient-specific drug problems through concurrent and retrospective review

D.

establishing protocols that require physicians to obtain certification of medical necessity prior to drug dispensing

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