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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

Greentree Medical, a health plan, is currently recruiting PCPs in preparation for its expansion into a new service area. Abigail Davis, a recruiter for Greentree, has been meeting with Melissa Cortelyou, M.D., in an effort to recruit her as a PCP in Green

Options:

A.

Greentree is prevented by law from offering a contract to Dr. Cortelyou until the credentialing process is complete

B.

any contract signed by Dr. Cortelyou should include a clause requiring the successful completion of the credentialing process within a defined time frame in order for the contract to be effective

C.

Greentree must offer a standard contract to Dr. Cortelyou, without regard to the outcome of the credentialing process

D.

Greentree will abandon the credentialing process now that Dr. Cortelyou has agreed to participate in Greentree's network

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Question 2

In health plan terminology, demand management, as used by health plans, can best be described as

Options:

A.

an evaluation of the medical necessity, efficiency, and/or appropriateness of healthcare services and treatment plans for a given patient

B.

a series of strategies designed to reduce plan members' needs to utilize healthcare services by encouraging preventive care, wellness, member self-care, and appropriate use of healthcare services

C.

a technique that prevents a provider who is being reimbursed under a fee schedule arrangement from billing a plan member for any fees that exceed the maximum fee reimbursed by the plan

D.

a system of identifying plan members with special healthcare needs, developing a healthcare strategy to meet those needs, and coordinating and monitoring the care

Question 3

Arthur Moyer is covered under his employer's group health plan, which must comply with the Consolidated Omnibus Budget Reconciliation Act (COBRA). Mr. Moyer is terminating his employment. He has elected to continue his coverage under his employer's group

Options:

A.

18 months, but his coverage under COBRA will cease if he obtains group health coverage through another employer.

B.

18 months, even if he obtains group health coverage through another employer.

C.

36 months, but his coverage under COBRA will cease if he obtains group health coverage through another employer.

D.

36 months, even if he obtains group health coverage through another employer.