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AHM-540 Exam Dumps : Medical Management

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Medical Management Questions and Answers

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Question 1

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)

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Question 2

Comorbidity can have a significant impact on the effective implementation of disease management programs. Comorbidity can correctly be defined as the

Options:

A.

degree to which the progression of a disease or condition is understood

B.

prevalence or rate of a sickness or injury within a given population

C.

degree of severity of a particular disease or condition

D.

presence of a chronic condition or added complication other than the condition that requires medical treatment

Question 3

The Brighton Health Plan regularly performs prospective UR for surgical procedures. Brighton’s prospective UR activities are likely to include

Options:

A.

documenting the clinical details of the patient’s condition and care

B.

tracking the length of inpatient stay

C.

completing the discharge planning process

D.

determining the most appropriate setting for the proposed course of care

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