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AHM-540 Exam Dumps : Medical Management

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Medical Management Questions and Answers

Question 1

This agency’s accreditation decisions are based on the results of an on-site survey of clinical and administrative systems and processes, as well as the health plan’s performance on selected effectiveness of care and member satisfaction measures.

Options:

A.

American Accreditation HealthCare Commission/URAC (URAC)

B.

Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

C.

Community Health Accreditation Program (CHAP)

D.

National Committee for Quality Assurance (NCQA)

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Question 2

Health plans that offer healthcare programs for Medicare beneficiaries have a strong financial incentive for identifying high-risk seniors as early as possible. The identification of high-risk seniors is typically accomplished through the use of

Options:

A.

case management

B.

geriatric evaluation and management (GEM)

C.

intervention identification

D.

interdisciplinary home care (IHC)

Question 3

PBMs are accredited by the same organizations that accredit health plans.

Options:

A.

True

B.

False