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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

The Courtland PPO maintains computerized records that include clinical, demographic, and administrative data about individual plan members. The data in these records is available to plan providers, ancillary service departments, pharmacies, and others inv

Options:

A.

a data warehouse

B.

a decision support system

C.

an outsourcing system

D.

an electronic medical record (EMR) system

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Question 2

Members who qualify to participate in a health plan's case management program are typically assigned a case manager. During the course of the member's treatment, the case manager is responsible for

Options:

A.

Coordinating and monitoring the member's care

B.

Approve

C.

Both A and B

D.

A only

E.

B only

F.

Neither A nor B

Question 3

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

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