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AHM-540 Exam Questions & Answers

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AHM-540 Exam Questions & Answers

Vendor: AHIP

Certifications: AHIP Certification

Exam Code: AHM-540

Exam Name: Medical Management

Updated: Dec 04, 2023

Q&As: 163

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Free AHM-540 Exam Questions in PDF Format

AHM-540 Online Practice Questions and Answers

Questions 1

The following statements are about medical management considerations for dental care. Select the answer choice containing the correct statement.

A. Managed dental care organizations are regulated at the state rather than the federal level.

B. Dental care differs from medical care in that most dental care is provided by specialists.

C. Dental preferred provider organizations (Dental PPOs) are subject to more regulation than are dental health maintenance organizations (DHMOs).

D. Managed dental plans are accredited by the National Association of Dental Plans (NADP).

Show Answer
Questions 2

Serena Wilson, a registered nurse, is employed at a TRICARE Service Center (TSC) located at a military installation. Ms. Wilson serves as a primary point of contact between enrollees and the TRICARE system and answers enrollees' questions about plan options, eligibility, provider selection, and claims. This information indicates that Ms. Wilson serves as a

A. lead agent

B. beneficiary services representative

C. health plan support contractor

D. primary care manager (PCM)

Show Answer
Questions 3

The paragraph below contains an incomplete statement. Select the answer choice containing the term that correctly completes the paragraph.

To manage the delivery of healthcare services to their members, health plans use clinical practice parameters. ___________________ is the type of clinical practice parameter that a health plan uses to make coverage decisions concerning medical necessity and appropriateness.

A. A clinical practice guideline (CPG)

B. Medical policy

C. Benefits administration policy

D. A standard of care

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