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AHM-540 Exam Questions

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AHM-540 Exam Questions

Free AHM-540 Exam Questions - AHIP AHM-540 Exam

AHIP AHM-540 Exam

AHM Medical Management

Total Questions: 163

Last Updated : 11-11-2024

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AHIP AHM-540 Exam Sample Questions:

Q1.

For this question, if answer choices (A) through (C) are all correct, select answer choice (D). Otherwise, select the one correct answer choice.

Ways that workers' compensation health plans can help control the costs of job-related injuries and illnesses include

Aapplying strict definitions of medical necessity

Bdeveloping prevention and recovery programs

Capplying out-of-network benefit reductions

Dall of the above

Q2.

Determine whether the following statement is true or false:

The key to successfully managing the quality and cost-effectiveness of healthcare services for Medicaid enrollees is to merge Medicaid recipients into existing plans.

ATrue

BFalse

Q3.

The following statements are about chronic and disabling conditions among children eligible for Medicaid. Three of the statements are true and one is false. Select the answer choice containing the FALSE statement.

AChildren with chronic conditions use more physician and nonphysician professional services than do children in the general population.

BThe majority of chronic conditions affecting children in Medicaid programs are the same as those affecting children in the general population.

CMedicaid-eligible children are at risk for seriousmental and physical conditions.

DChildren in Medicaid programs have a higher incidence of chronic disabling conditions than do children in the general population.

Q4.

The Medicaid population can be divided into subgroups based on their relative size and the costs of providing benefits. From the answer choices below, select the response that correctly identifies the subgroups that represent the largest percentages of the total Medicaid population and of total Medicaid expenditures. Largest % of Medicaid Population- Largest % of Medicaid Expenditures-

ALargest % of Medicaid Population-dual eligibles Largest % of Medicaid Expenditures-children and low-income adults

BLargest % of Medicaid Population-chronically ill or disabled individuals not eligible for MedicareLargest % of Medicaid Expenditures-dual eligibles

CLargest % of Medicaid Population-children and low-income adults Largest % of Medicaid Expenditures-chronically ill or disabled individuals not eligible for Medicare

DLargest % of Medicaid Population-chronically ill or disabled individuals not eligible for Medicare Largest % of Medicaid Expenditures-children and low-income adults

Q5.

The following statements are about QAPI as it applies to Medicare+Choice plans and Medicaid health plan entities. Select the answer choice containing the correct statement.

AQAPI provides separate sets of standards for Medicaid MCEs and Medicare+Choice plans.

BMedicaid primary care case management (PCCM) programs are required to comply with all QAPI standards.

CQISMC standards for quality measurement and improvement apply only to clinical services delivered to Medicare and Medicaid enrollees.

DStates that require Medicaid MCEs to comply with QAPI standards are considered to be in compliance with CMS quality assessment and improvement regulations.

Solutions:

Question: 1 Answer: B

Question: 2 Answer: B

Question: 3 Answer: B

Question: 4 Answer: C

Question: 5 Answer: D