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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

During the risk assessment process for a traditional indemnity group insurance health plan, group underwriters consider such characteristics as a group’s geographic location, the size and gender mix of the group, and the level of participation in the grou

Options:

A.

Healthcare costs are typically higher in rural areas than in large urban areas.

B.

The morbidity rate for males is higher than the morbidity rate for females.

C.

The larger the group, the more likely it is that the group will experience losses similar to the average rate of loss that was predicted.

D.

All of the above

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Question 2

Paul Gilbert has been covered by a group health plan for two years. He has been undergoing treatment for angina for the past three months. Last week, Mr. Gilbert began a new job and immediately enrolled in his new company's group health plan, which has a

Options:

A.

Can exclude coverage for treatment of Mr. Gilbert's angina for one year, because HIPAA does not impact a group health plan's pre-existing condition provision.

B.

Can exclude coverage for treatment of Mr. Gilbert's angina for one year, because Mr. Gilbert did not have at least 36 months of creditable coverage under his previous health plan.

C.

Can exclude coverage for treatment of Mr. Gilbert's angina for three months, because that is the length of time he received treatment for this medical condition prior to his enrollment in the new health plan.

D.

Cannot exclude his angina as a pre-existing condition, because the one-year pre-existing condition provision is offset by at least one year of continuous coverage under his previous health plan.

Question 3

Medicaid is a jointly funded federal and state program that provides hospital and medical expense coverage to low-income individuals and certain aged and disabled individuals. One characteristic of Medicaid is that

Options:

A.

providers who care for Medicaid recipients must accept Medicaid payment as payment in full for services rendered

B.

Medicaid requires recipients to pay deductibles, copayments, and coinsurance amounts for all services

C.

Medicaid is always the primary payer of benefits

D.

benefits offered by Medicaid programs are federally mandated and do not vary by state