AHIP AHM-250 Healthcare Management: An Introduction Version: 1.0 Practice Exams II

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QUESTION NO: 101 In the paragraph below, two statements each contain a pair of terms enclosed in parentheses. Determine which term correctly completes each statement. Then select the answer choice containing the two terms that you have chosen. For providers, (operational /

1 point

A. operational / an acquisition

B. operational / a consolidation

C. structural / an acquisition

D. structural / a consolidation

Clear selection

QUESTION NO: 102 In the United States, the Department of Defense offers ongoing healthcare coverage to military personnel and their families through the TRICARE health plan. One true statement about TRICARE is that

1 point

A. hospitals participating in TRICARE program are exempt from JCAHO accreditation and Medicare certification

B. TRICARE enrollees are not entitled to appeal authorization coverage decisions

C. active duty personnel are automatically considered enrolled in TRICARE Prime

D. TRICARE covers inpatient and outpatient services, physician and hospital charges, and medical supplies, but not mental health services

Clear selection

QUESTION NO: 103 In the United States, the Department of Defense offers ongoing healthcare coverage to military personnel and their families through the TRICARE health plan. One true statement about TRICARE is that:

1 point

A. Active duty military personnel are automatically considered enrolled in TRICARE Prime

B. TRICARE covers inpatient and outpatient services, physician and hospital charges, and medical supplies, but not mental health services.

C. TRICARE enrollees are not entitled to appeal authorization or coverage decisions

D. Hospitals participating in the TRICARE program are exempt from JCAHO accreditation and Medicare certification.

Clear selection

QUESTION NO: 104 Individuals can use HSAs to pay for the following types of health coverage:

1 point

A. Qualified disability insurance

B. COBRA continuation coverage.

C. Medigap coverage (for those over 65).

D. All of the above.

Clear selection

QUESTION NO: 105 Janet Riva is covered by an indemnity health insurance plan that specifies a $250 deductible and includes a 20% coinsurance provision. When Ms. Riva was hospitalized, she incurred $2,500 in medical expenses that were covered by her health plan. She incurred

1 point

A. $1,750

B. $1,800

C. $2,000

D. $2,250

Clear selection

QUESTION NO: 106 Janet Riva is covered by a traditional indemnity health insurance plan that specifies a $250deductible and includes a 20% coinsurance provision. When Ms. Riva was hospitalized, she incurred $2,500 in medical expenses that were covered by her health plan.

1 point

A. $1,750

B. $1,800

C. $2,000

D. $2,250

Clear selection

QUESTION NO: 107 John Kerry's employer has contracted to receive healthcare for its employees from the Democratic Healthcare System. Mr. Kerry visits his PCP, who sends him to have some blood tests. The PCP then refers Mr. Kerry to a specialist who hospitalizes him for on

1 point

A. a physician practice organization

B. a physician-hospital organization

C. a management services organization

D. an integrated delivery system

Clear selection

QUESTION NO: 108 Khalyn Drury's employer includes managed dental care in its employee benefits package. During open enrollment, Ms. Drury enrolled in the dental plan, which provides dental services to its members in exchange for a prepayment (the premium). Dental services:

1 point

A. dental preferred provider organization (PPO)

B. traditional fee-for-service (FFS) dental plan

C. plan with a dental point of service (POS) option

D. dental health maintenance organization (DHMO)

Clear selection

QUESTION NO: 109 Lansdale Healthcare, a health plan, offers comprehensive healthcare coverage to its members through a network of physicians, hospitals, and other service providers. Plan members who use in network services pay a copayment for these services. The copayment Lunsford requires members to pay for in-network services is best defined as a

1 point

A. specified dollar amount charge that a plan member must pay out-of-pocket for a specified medical service at the time the service is rendered

B. percentage of the fees for medical services that a plan member must pay after Magellan has paid its share of the costs of those services

C. flat amount that a plan member must pay each year before Magellan will make any benefit payments on behalf of the plan member

D. specified payment for services that was negotiated between the provider and Magellan

Clear selection

QUESTION NO: 110 Managed behavioral health organizations (MBHOs) use several strategies to manage the delivery of behavioral healthcare services. The following statements are about these strategies. Select the answer choice that contains the correct statement.

1 point

A. MBHOs generally provide benefits for mental health services but not for chemical dependency services.

B. The level of care needed to treat behavioral disorders is the same for all patients and all disorders.

C. By using outpatient treatment more extensively, MBHOs have decreased the use of costly inpatient therapies.

D. PCP gatekeeper systems for behavioral healthcare generally result in more accurate diagnoses, more effective treatment, and more efficient use of resources than do centralized referral systems.

Clear selection

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