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AHM-540 Exam Questions & Answers

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AHM-540 Exam Questions & Answers

Vendor: AHIP

Certifications: AHIP Certifications

Exam Code: AHM-540

Exam Name: Medical Management

Updated: Jun 28, 2025

Q&As: 163

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AHIP AHM-540 Last Month Results

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AHM-540 Online Practice Questions and Answers

Questions 1

Determine whether the following statement is true or false:

Independent review organizations (IROs) can mediate disputes and offer advisory opinions to health plans on UR issues, but they cannot render binding decisions on appeals.

A. True

B. False

Show Answer
Questions 2

One way that health plans evaluate their UR programs is by monitoring utilization rates. By definition, utilization rates typically

A. indicate changes in the total amount of medical expenses or claim dollars paid for particular procedures

B. measure the number of services provided per 1,000 members per year

C. indicate standard approaches to care for many common, uncomplicated healthcare services

D. report the number of times that a particular provider performs or recommends a service excluded from the benefit plan

Show Answer
Questions 3

In recent years, the demand for prescription drugs has increased dramatically. Factors that have contributed to this increase include

A. increased education regarding the purpose and benefits of drug formularies

B. reductions in the cost of prescription drugs

C. increased use of direct-to-consumer (DTC) advertising

D. all of the above

Show Answer More Questions

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