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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

Amendments to the HMO act 1973 do not permit federally qualified HMO’s to use

Options:

A.

Retrospective experience rating

B.

Adjusted community rating

C.

Community rating by class

D.

Community rating

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Question 2

Utilization review offers health plans a means of managing costs by managing

Options:

A.

Cost effectiveness of healthcare services.

B.

Cost of paying healthcare benefits.

C.

Both of the above

Question 3

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