Discuss AHIP AHM-520 Exam Topic 4 Question 3

Rasheed Azari, the risk manager for the Tower health plan, is attempting to work with providers in the organization in order to reduce the providers' exposure related to utilization review. Mr. Azari is considering advising the providers to take the following actions:

-1-Allow Tower's utilization management decisions to override a physician's independent medical judgment

-2-Support the development of a system that can quickly render a second opinion in case of disagreement surrounding clinical judgment

-3-Inform a patient of any issues that are being disputed relative to a physician's recommended treatment plan and Tower's coverage decision

Of these possible actions, the ones that are likely to reduce physicians' exposures related to utilization review include actions

A1, 2, and 3

B1 and 2 only

C1 and 3 only

D2 and 3 only

Suggested Answer: D

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10 comments · newest first

Loreta 1 year ago

1 seems risky, but 3 is definitely a must!

Rodolfo 1 year ago

Totally agree with 2 and 3, they seem necessary.

Malissa 1 year ago

Surprised they’d even consider overriding a physician's judgment!

Ryan 1 year ago

Not sure about allowing management to override doctors.

Talia 1 year ago

I think 2 and 3 make the most sense.

Danilo 1 year ago

Okay, I remember learning that etcd is the backend storage system for the Kubernetes API, so I'm going to go with D. It stores all the cluster's state and metadata.

Jaime 1 year ago

From what I studied, BFD is definitely used for link quality, but I might be mixing it up with its role in other protocols.

Dell 1 year ago

The key to this question is understanding how $set works in MongoDB. It updates the value of a specific field in a document, so the correct answer has to be "name/value pair". I feel good about this one.

Antonio 1 year ago

If I recall correctly, SDX provides that multi-tenant capability. It's been part of our practice questions quite a bit.

Rosalind 1 year ago

I'm a bit confused on this one. I'll need to review the details on how the Default measure property works in a Crosstab.

AHIP AHM-520 Exam - Topic 4 Question 3 Discussion