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AHM-540 Exam Dumps : Medical Management

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Medical Management Questions and Answers

Question 1

To see that utilization guidelines are consistently applied, UR programs rely on authorization systems. Determine whether the following statement about authorization systems is true or false:

Only physicians can make nonauthorization decisions based on medical necessity.

Options:

A.

True

B.

False

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Question 2

The following statements are about medical management considerations for dental care. Select the answer choice containing the correct statement.

Options:

A.

Managed dental care organizations are regulated at the state rather than the federal level.

B.

Dental care differs from medical care in that most dental care is provided by specialists.

C.

Dental preferred provider organizations (Dental PPOs) are subject to more regulation than are dental health maintenance organizations (DHMOs).

D.

Managed dental plans are accredited by the National Association of Dental Plans (NADP).

Question 3

Health plans often use accreditation as a means of evaluating the quality of care delivered to plan members. Accreditation of subacute care providers is available from the

Options:

A.

National Committee for Quality Assurance (NCQA)

B.

Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

C.

American Accreditation HealthCare Commission/URAC (URAC)

D.

Foundation for Accountability (FACCT)