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AHM-250 Exam Dumps : Healthcare Management: An Introduction

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Healthcare Management: An Introduction Questions and Answers

Question 1

Primary care case managers (PCCMs) provide managed healthcare services to eligible Medicaid recipients. With regard to PCCMs, it is correct to say that

Options:

A.

PCCMs contract directly with the federal government to provide case management services to Medicaid recipients

B.

all Medicaid recipients who live in rural areas must be given a choice of at least four PCCMs

C.

Medicaid PCCM programs are exempt from the Health Care Financing Administration's (HCFA's) Quality Improvement System for Managed Care (QISMC) standards

D.

PCCMs typically receive a case management fee, rather than reimbursement for medical services on a FFS basis, for the services they provide to Medicaid recipients

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Question 2

The contract between the Honolulu MCO and Beverley Hills Hospital contains a 90 day cure provision. The Beverley Hills Hospital breached one of the contract requirements on July 31, 2004. The hospital remedied the problem by October 31, 2004. Which of the

Options:

A.

The contract would not be terminated as Beverley Hills hospital rectified the problem within 90 days.

B.

The contract would be terminated as Beverley Hills hospital was required to notify Honolulu MCO about the problem at least 90 days in advance.

C.

The contract would be terminated as Beverley Hills hospital was required to rectify the problem within 90 days.

D.

The contract would not be terminated as Beverley Hills hospital may escape adherence to the cure provision.

Question 3

Health plans require utilization review for all services administered by its participating physicians.

Options:

A.

True

B.

False