AHIP AHM-250 Exam - Topic 6 Question 87 Discussion

Actual exam question for AHIP's AHM-250 exam

Question #: 87
Topic #: 6

Natalie Chan is a member of the Ultra Health Plan, a health plan. Whenever she needs nonemergency medical care, she sees Dr. David Craig, an internist. Ms. Chan cannot self-refer to a specialist, so she saw Dr. Craig when she experienced headaches. Dr. Cr

AWithin Ultra's system, Ms. Chan received primary care from both Dr. Craig and Dr. Lee

BUltra's system allows its members open access to all of Ultra's participating providers.

CWithin Ultra's system, Dr. Craig serves as a coordinator of care or gatekeeper for the medical services that Ms. Chan receives.

DUltra's network of providers includes Dr. Craig and Dr. Lee but not Arrow Hospital

Show Suggested Answer

Suggested Answer: A

by Ronnie at May 12, 2024, 01:20 PM

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Art

4 months ago

Not sure about Dr. Lee being involved; sounds off to me.

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Lezlie

4 months ago

Ultra's system is all about that coordinated care!

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Kaycee

4 months ago

Wait, so she can't just go to a specialist directly? That's surprising.

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Aliza

4 months ago

I thought members could see any provider in the network?

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Tiffiny

5 months ago

Dr. Craig is definitely the gatekeeper for Ms. Chan's care.

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Jose

5 months ago

I vaguely recall something about provider networks, but I can't remember if Arrow Hospital was included or not.

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Alesia

5 months ago

This question seems similar to one we practiced about primary care providers and their roles. I think Dr. Craig is definitely acting as a gatekeeper here.

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Yolande

5 months ago

I'm not entirely sure, but I feel like the option about open access doesn't fit because Ms. Chan can't self-refer.

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Cammy

5 months ago

I remember something about gatekeeping in managed care, so I think Dr. Craig might be the one coordinating Ms. Chan's care.

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Yaeko

5 months ago

Hmm, I'm a little unsure about this one. The information provided is fairly detailed, but I'm not entirely sure how to apply it to determine the correct answer. I'll need to re-read the question and options carefully.

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Tamesha

5 months ago

This is a classic health plan question. I've seen similar ones before, so I feel pretty confident I can figure this out. I'll read through the details one more time to make sure I don't miss anything.

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Jina

5 months ago

Okay, I think I've got a handle on this. The key seems to be understanding the role of Dr. Craig as the primary care provider or "gatekeeper" within the Ultra Health Plan. I'll select the option that best describes that.

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Shawnda

5 months ago

Hmm, I'm a little confused by the wording here. It's not entirely clear to me how the plan's system works in terms of member access to providers. I'll need to think through the options carefully.

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Alyssa

6 months ago

This seems like a straightforward question about the structure and rules of the Ultra Health Plan. I'll need to carefully read through the details provided to determine how Ms. Chan's care is coordinated within the plan.

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Robt

6 months ago

Okay, let's think this through. We need to scale up when the divers are filling out the questionnaire, and then scale back down after they're done. I think a recurrence profile could be a good option, since we know the questionnaire is filled out every 15 days. That way, we can schedule the scaling to match the usage patterns.

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Ryann

6 months ago

This seems like a straightforward question. I'd go with option B - document the existing environment and use SPOCK to check compatibility.

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Elly

6 months ago

This seems like a straightforward data visualization question. I'd probably start by thinking about the type of data we're working with - percentages over time. An equal-interval line graph could be a good option to show the trend.

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Truman

6 months ago

I feel like there was something about removing the need for saved credentials, but I can't recall if that's option C.

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Marge

6 months ago

I feel pretty confident that navigation bars would be the most user-friendly option for an elementary school website with multiple sections.

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Nichelle

6 months ago

This seems like a straightforward question. I think option B is the way to go - using CRC32C hashes to verify the uploaded files is a smart and efficient approach.

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Luisa

11 months ago

I'm just glad I don't have to deal with all these gatekeepers and networks. I'll stick to my trusty old doctor, thank you very much!

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Gwenn

11 months ago

Well, at least she's not stuck with Dr. Lee - I heard he has a terrible bedside manner. Good thing she has Dr. Craig looking out for her.

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Yuette

9 months ago

B) Ultra's system allows its members open access to all of Ultra's participating providers.

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Dannie

10 months ago

C) Within Ultra's system, Dr. Craig serves as a coordinator of care or gatekeeper for the medical services that Ms. Chan receives.

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Dorsey

10 months ago

A) Within Ultra's system, Ms. Chan received primary care from both Dr. Craig and Dr. Lee

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Jennie

11 months ago

Haha, I hope Dr. Craig doesn't have a long waiting list, or Ms. Chan might be stuck with those headaches for a while!

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Hannah

10 months ago

D) Ultra's network of providers includes Dr. Craig and Dr. Lee but not Arrow Hospital

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Shawn

10 months ago

B) Ultra's system allows its members open access to all of Ultra's participating providers.

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Ronny

10 months ago

C) Within Ultra's system, Dr. Craig serves as a coordinator of care or gatekeeper for the medical services that Ms. Chan receives.

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Isaiah

11 months ago

A) Within Ultra's system, Ms. Chan received primary care from both Dr. Craig and Dr. Lee

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Cathrine

11 months ago

I agree, option C makes the most sense. The question clearly states that Ms. Chan cannot self-refer to a specialist, so Dr. Craig must be serving as a coordinator of her care.

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Bettina

11 months ago

I'm not sure, but I think the answer might also be A, as Ms. Chan receives primary care from both Dr. Craig and Dr. Lee.

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Jesus

11 months ago

I agree with Willow, Dr. Craig coordinates Ms. Chan's care within Ultra's system.

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Dahlia

11 months ago

The correct answer here is C. Ultra's system requires members to go through a primary care provider like Dr. Craig as a gatekeeper before accessing specialist care.

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