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AHIP Exam AHM-540 Topic 1 Question 104 Discussion

Actual exam question for AHIP's AHM-540 exam
Question #: 104
Topic #: 1
[All AHM-540 Questions]

To see that utilization guidelines are consistently applied, UR programs rely on authorization systems. Determine whether the following statement about authorization systems is true or false:

Only physicians can make nonauthorization decisions based on medical necessity.

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Suggested Answer: B

by Elmira at Dec 09, 2024, 11:35 AM

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Rosalind
1 days ago
This is a tricky one. While physicians typically have the final say on medical necessity, some UR programs may allow other qualified healthcare professionals to make nonauthorization decisions as well. I'll have to think carefully about this one.
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Ryan
6 days ago
I disagree. I believe only physicians should make such decisions.
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Aliza
7 days ago
I agree with Cecily. Nonphysicians can also make nonauthorization decisions based on medical necessity.
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Cecily
9 days ago
I think the statement is false.
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