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AHM-250 Exam Dumps : Healthcare Management: An Introduction

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Healthcare Management: An Introduction Questions and Answers

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Question 1

Natalie Chan is a member of the Ultra Health Plan, a health plan. Whenever she needs nonemergency medical care, she sees Dr. David Craig, an internist. Ms. Chan cannot self-refer to a specialist, so she saw Dr. Craig when she experienced headaches. Dr. Cr

Options:

A.

Within Ultra's system, Ms. Chan received primary care from both Dr. Craig and Dr. Lee

B.

Ultra's system allows its members open access to all of Ultra's participating providers.

C.

Within Ultra's system, Dr. Craig serves as a coordinator of care or gatekeeper for the medical services that Ms. Chan receives.

D.

Ultra's network of providers includes Dr. Craig and Dr. Lee but not Arrow Hospital

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Question 2

Many of the credentialing standards and criteria used by health plans are often taken from already existing standards established by

Options:

A.

the National Practitioner Data Bank (NPDB)

B.

the National Association of Insurance Commissioners (NAIC)

C.

the Centers for Medicare and Medicaid Services (CMS)

D.

independent accrediting organizations

Question 3

One type of physician-only integration model is a consolidated medical group. Typical characteristics of a consolidated medical group include

Options:

A.

that it may be a single-specialty or multi-specialty practice

B.

operates in one or a few facilities rather than in many independent offices

C.

achieves economies of scale in the group's integrated operations

D.

all of the above

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