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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

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

Options:

A.

True

B.

False

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Question 2

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

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)

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