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AHM-540 Exam Dumps : Medical Management

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Medical Management Questions and Answers

Question 1

In most health plans, the formulary system is developed and managed by a P&T committee. The P&T committee is responsible for

Options:

A.

evaluating and selecting drugs for inclusion in the formulary

B.

overseeing the manufacture, distribution, and marketing of prescription drugs

C.

certifying the medical necessity of expensive, potentially toxic, or nonformulary drugs

D.

all of the above

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Question 2

As a follow-up to a performance improvement plan for member services, the Stellar Health Plan conducted an evaluation of the success of the plan. Stellar conducted its evaluation as the plan was being carried out. The evaluation focused on specific activities and assessed the relative importance of those activities to the plan as a whole. This information indicates that Stellar’s evaluation of the plan was both

Options:

A.

concurrent and formative

B.

concurrent and summative

C.

retrospective and formative

D.

retrospective and summative

Question 3

Health plans arrange for the delivery of various levels of healthcare, including

1. Emergency care

2. Urgent care

3. Primary care delivered in a provider’s office

In a ranking of these levels of care according to cost, beginning with the least expensive level of care and ending with the most expensive level of care, the correct order would be

Options:

A.

1—2—3

B.

2—3—1

C.

3—1—2

D.

3—2—1