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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 nature of behavioral healthcare creates unique medical management challenges for health plans. One method health plans have used to support the delivery of appropriate services in a cost-effective manner is to

Options:

A.

remove behavioral healthcare services from the primary care setting

B.

shift behavioral healthcare from acute inpatient settings to alternative settings when feasible

C.

reserve the use of psychotherapy for treatment of those conditions that persist over long periods of time or for the life of the patient

D.

offer the same level of compensation to all of the professional disciplines that provide behavioral healthcare services to plan members

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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