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AHM-510 Dumps With Exact Questions and Answers

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AHM-510 Questions and Answers

Question # 1

The government uses various tools within the realm of two broad categories of public policy-allocative policies and regulatory policies. In the context of public policy, laws that fall into the category of allocative policy include

A.

The Balanced Budget Act (BBA) of 1997

B.

The Health Insurance Portability and Accountability Act (HIPAA) of 1996

C.

Laws affecting health plan quality oversight

D.

Laws specifying procedures for health plan handling of consumer appeals and grievances

Question # 2

In the course of doing business, health plans conduct basic corporate transactions. For example, when a health plan engages in the corporate transaction known as aggressive sourcing, the health plan

A.

Chooses to contract with vendors who provide specific functions that would otherwise be performed in-house, such as paying claims

B.

Seeks to obtain the best deals from various vendors for equipment, supplies, and services such as telephones, overnight mail, computer hardware and software, and copy machines

C.

Merges with one or more companies to form an entirely new company

D.

Joins with one or more companies, but retains its autonomy and relies on the other companies to perform specific functions

Question # 3

Several states have adopted clinical practice guidelines for treating workers' compensation injuries. Clinical practice guidelines can best be described as

A.

Fee schedules that specify the maximum amount providers may charge for treating workers' compensation patients

B.

A utilization management and quality management mechanism designed to aid providers in making decisions about the most appropriate course of treatment for a specific case

C.

Detailed plans of medical treatment designed to facilitate a patient's return to the workplace

D.

Payment practices that might technically violate the provisions of the anti-kickback statute but that will not be considered illegal and for which providers and health plans will not be subject to penalties

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