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Medical Management: AHM-540
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- Vendor: AHIP
- Exam Code: AHM-540
- Exam Name: Medical Management
- Certifications: AHIP Certification
- Total Questions: 163 Q&As
- Updated on: Dec 15, 2024
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Free AHM-540 Exam Questions in PDF Format
Related AHIP Certification Exams
AHM-540 Online Practice Questions and Answers
Questions 1
Most health plans require a PCP referral or precertification for CAM benefits.
A. True
B. False
Questions 2
The paragraph below contains an incomplete statement. Select the answer choice containing the term that correctly completes the paragraph.
The Balanced Budget Act (BBA) of 1997 established the use of ___________ to determine coverage of emergency services for Medicare and Medicaid enrollees in health plans.
A. utilization management standards
B. the prudent layperson standard
C. preauthorization
D. diagnosis-based retrospective review
Questions 3
The paragraph below contains two pairs of terms or phrases enclosed in parentheses. Determine which term or phrase in each pair correctly completes the paragraph. Then select the answer choice containing the terms or phrases that you have chosen.
One component of UR is an administrative review. An administrative review compares the proposed medical care to the applicable (medical policy / contract provision). This type of review (can / cannot) be conducted by a nonclinical staff member.
A. medical policy / can
B. medical policy / cannot
C. contract provision / can
D. contract provision / cannot
Reviews
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