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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

The contract between the Honolulu MCO and Beverley Hills Hospital contains a 90 day cure provision. The Beverley Hills Hospital breached one of the contract requirements on July 31, 2004. The hospital remedied the problem by October 31, 2004. Which of the

Options:

A.

The contract would not be terminated as Beverley Hills hospital rectified the problem within 90 days.

B.

The contract would be terminated as Beverley Hills hospital was required to notify Honolulu MCO about the problem at least 90 days in advance.

C.

The contract would be terminated as Beverley Hills hospital was required to rectify the problem within 90 days.

D.

The contract would not be terminated as Beverley Hills hospital may escape adherence to the cure provision.

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Question 2

The following statements describe violations of antitrust legislation:

Situation A - Two health plans in a single service area divided purchasers into two groups and agreed to each market their products to only one purchaser group.

Situation B - A spec

Options:

A.

Situation A - horizontal division of markets Situation B - tying arrangement.

B.

Situation A - horizontal division of markets Situation B - price fixing.

C.

Situation A - horizontal group boycott Situation B - tying arrangement.

D.

Situation A - horizontal group boycott Situation B - price fixing.

Question 3

If left unresolved, member complaints about the actions or decisions made by a health plan or its providers can lead to formal appeals. One procedure health plans can use to address formal appeals is to submit the original decision and any supporting info

Options:

A.

A Level One appeal, and the member has the right to a further appeal

B.

A Level Two appeal, and the reviewer's decision is final and binding

C.

An independent external appeal, and the member has the right to a further appeal

D.

Arbitration, and the reviewer's decision is final and binding