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AHIP AHM-540 Exam Dumps

Vendor: AHIP
Exam Code: AHM-540
Exam Name: Medical Management
Certification: AHIP Certification
Total Questions: 163 Q&A
Updated on: Dec 16, 2024
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AHM-540 Online Practice Questions and Answers

Questions 1

The following statement(s) can correctly be made about the scope of case management:

1.Case management incorporates activities that may fall outside a health plan's typical responsibilities, such as assessing a member's financial situation

2.Case management generally requires a less comprehensive and complex approach to a course of care than does utilization review

3.Case management is currently applicable only to medical conditions that require inpatient hospital care and are categorized as catastrophic in terms of health and/or costs

A. All of the above

B. 1 and 2 only

C. 2 and 3 only

D. 1 only

Show Answer

Questions 2

One of the steps in drug utilization review (DUR) is defining optimal drug use, which can be accomplished by applying diagnosis criteria and drug-specific criteria. Drug-specific criteria are standards that identify the

A. appropriate dosages, duration of treatment, and other elements related to the use of a particular drug

B. actual prescribing and dispensing patterns for a particular drug

C. types of diseases, conditions, or patients for which a drug should be used

D. cost-effectiveness of all possible drug treatments for a particular condition

Show Answer

Questions 3

7. One method that health plans use to address provider compliance with formularies is academic detailing.

A. True

B. False

Show Answer More Questions

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