Vendor: AHIP
Certifications: AHIP Certification
Exam Code: AHM-540
Exam Name: Medical Management
Updated: Jun 30, 2022
Q&As: 163
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Occasionally, employers combine workers' compensation, group healthcare, and disability programs into an integrated product known as 24-hour coverage. One true statement about 24-hour coverage is that it typically
A. increases administrative costs
B. requires plans to maintain separate databases of patient care information
C. exempts plans from complying with state workers' compensation regulations
D. allows plans to apply disability management and return-to-work techniques to nonoccupational conditions
The following statements are about the use of hospitalists to manage inpatient care. Select the answer choice containing the correct statement.
A. A patient who has been transferred to a hospitalist for management of inpatient care usually continues to receive care from the hospitalist after discharge.
B. Hospitalists are used primarily to manage care for obstetric, pediatric, and oncology patients.
C. In order to serve as a hospitalist, a physician must have a background in critical care medicine.
D. Hospitalists typically spend at least one-quarter of their time in a hospital setting.
The following statements are about the use of provider profiling for pharmacy benefits. Three of the statements are true and one is false. Select the answer choice containing the FALSE statement.
A. Health plans typically use provider profiles to improve the quality of care associated with the use of prescription drugs.
B. Provider profiles identify prescribing patterns that fall outside normal ranges.
C. Health plans can motivate providers to change their prescribing patterns by sharing profile information with plan members and the general public.
D. Provider profiles are effective in modifying individual prescribing patterns, but they have little effect on group prescribing patterns.
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