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AHIP AHM-540 Exam With Confidence Using Practice Dumps

Exam Code:
AHM-540
Exam Name:
Medical Management
Certification:
Vendor:
Questions:
163
Last Updated:
Apr 18, 2026
Exam Status:
Stable
AHIP AHM-540

AHM-540: AHIP Certification Exam 2025 Study Guide Pdf and Test Engine

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Medical Management Questions and Answers

Question 1

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

Options:

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).

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Question 2

Adele Stanley, a member of the Greenhouse Health Plan, recently went to a network pharmacy to have a prescription filled. The pharmacist informed Ms. Stanley that the prescribed drug was not in the plan formulary and that reimbursement for the drug was not available except in extraordinary circumstances. The pharmacist asked Ms. Stanley if she would accept a generic substitute.

If Ms. Stanley agrees to the generic substitution, she will receive a drug that

Options:

A.

has not been tested for safety and efficacy in large clinical trials

B.

is available without a prescription at a reasonable cost

C.

has been classified by the Food and Drug Administration (FDA) as safe, but that has not been proven fully effective

D.

contains active ingredients that are identical to those of the prescribed brand-name drug

Question 3

With respect to the activities of MCO medical directors, it is correct to say that medical directors typically perform all of the following activities EXCEPT

Options:

A.

maintaining clinical practices

B.

delivering performance feedback to providers

C.

participating in utilization management (UM) activities

D.

educating other MCO staff about new clinical developments or provider innovations that might impact clinical practice management