Free AHIP AHM-530 Exam Dumps

Here you can find all the free questions related with AHIP Network Management (AHM-530) exam. You can also find on this page links to recently updated premium files with which you can practice for actual AHIP Network Management Exam. These premium versions are provided as AHM-530 exam practice tests, both as desktop software and browser based application, you can use whatever suits your style. Feel free to try the Network Management Exam premium files for free, Good luck with your AHIP Network Management Exam.

Question No: 1

MultipleChoice

Grant Pelham is covered by both a workers' compensation program and a group health plan provided by his employer. The Shipwright Health Plan administers both programs. Mr. Grant was injured while on the job and applied for benefits.

Because Mr. Pelham was injured on the job, he is entitled to receive benefits through workers' compensation. Under the terms of the state-mandated exclusive remedy doctrine included in the workers' compensation agreement, Mr. Pelham will most likely be prohibited from

Options

AReceiving workers' compensation benefits unless he can show that the employer was at fault for his injury

BObtaining care from providers who are not members of a workers' compensation network

CSuing his employer for additional benefits

DClaiming benefits from both workers' compensation and his group health plan

Question No: 2

MultipleChoice

The BBA of 1997 specifies the ways in which a Medicare+Choice plan can establish and use provider networks. A Medicare+Choice plan that operates as a private fee for service (PFFS) plan is allowed to

Options

Alimit the size of its network to the number of providers necessary to meet the needs of its enrollees

Brequire providers to accept as payment in full an amount no greater than 115% of the Medicare payment rate

Crefuse payment to non-network providers who submit claims for Medicare-covered expenses

Dshift all risk for Medicare-covered services to network providers

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