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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

For this question, if answer choices (a) through (c) are all correct, select answer choice (d). Otherwise, select the one correct answer choice.

Well-crafted clinical practice guidelines (CPGs) can benefit healthcare delivery processes and outcomes by

Options:

A.

providing a framework for care while also allowing for patient-specific variations, based on physician judgment

B.

serving as a basis for evaluating whether providers are practicing in accordance with accepted standards

C.

focusing on the prevention or early detection of a particular condition

D.

all of the above

Question 3

Michelle Durden, who is enrolled in a dental health maintenance organizations (DHMO) offered by her employer, is due for a routine dental examination. If the plan is typical of most DHMOs, then Ms. Durden

Options:

A.

must pay the entire cost of the examination

B.

must obtain a referral to a dentist from her primary care provider (PCP)

C.

can schedule the examination without preauthorization of payment by the DHMO

D.

can schedule an unlimited number of examinations and cleanings per year

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