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AHM-530 Exam Dumps : Network Management

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Question 1

The following statement(s) can correctly be made about the Balanced Budget Act (BBA) of 1997:

Options:

A.

The BBA requires Medicare+Choice organizations to be licensed as non-risk-bearing entities under federal law.

B.

The Centers for Medicaid and Medicare Services (CMS) is responsible for implementing the BBA.

C.

Both A and B

D.

A only

E.

B only

F.

Neither A nor B

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Question 2

An health plan’s contract negotiation team consists of several skilled individuals from different areas. At least one of the members is responsible for evaluating the wording of specific clauses to ensure that the health plan’s rights are protected, as well as to ensure that the contract is in compliance with state and federal regulation. By profession, this member of the contract negotiation team is typically

Options:

A.

Amedical director

B.

An attorney

C.

Afinancial manager

D.

Aclaims manager

Question 3

The provider contract that Dr. Laura Cartier has with the Sailboat health plan includes a section known as the recitals. Dr. Cartier's contract includes the following statements:

Options:

A.

A statement that identifies the purpose of the contract

B.

A statement that defines in legal terms the parties to the contract

C.

A statement that identifies the Sailboat products to be covered by the contract

Of these statements, the ones that are likely to be included in the recitals section of Dr. Cartier's contract are statements:

D.

A, B, and C

E.

A and B only

F.

A and C only

G.

B and C only

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