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AHM-530 Exam Dumps : Network Management

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Network Management Questions and Answers

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

From the following answer choices, choose the type of clause or provision described in this situation.

The provider contract between Dr. Olin Norquist and the Granite Health Plan specifies a time period for the party who has breached the contract to remedy the problem and avoid termination of the contract.

Options:

A.

Cure provision

B.

Hold-harmless provision

C.

Evergreen clause

D.

Exculpation clause

Question 3

During the credentialing process, a health plan verifies the accuracy of information on a prospective network provider’s application. One true statement regarding this process is that the health plan

Options:

A.

has a legal right to access a prospective provider’s confidential medical records at any time

B.

must limit any evaluations of a prospective provider’s office to an assessment of quantitative factors, such as the number of double-booked appointments a physicianaccepts at the end of each day

C.

is prohibited by law from conducting primary verification of such data as a prospective provider’s scope of medical malpractice insurance coverage and federal tax identification number

D.

must complete the credentialing process before a provider signs the network contract or must include in the signed document a provision that the final contract is contingent upon the completion of the credentialing process