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AHIP AHM-540 Exam - Topic 3 Question 87 Discussion

The paragraph below contains two pairs of terms or phrases enclosed in parentheses. Determine which term or phrase in each pair correctly completes the paragraph. Then select the answer choice containing the terms or phrases that you have chosen.Due to competitive pressures and consumer demand, many health plans now offer direct access or open access products. Under a direct access product, a member is (required / not required) to select a primary care provider (PCP), and is (required / not required) to obtain a referral from a PCP or the health plan before visiting a network specialist.
B) required / not required
A) required / required
C) not required / required
D) not required / not required

AHIP AHM-540 Exam - Topic 3 Question 87 Discussion

Actual exam question for AHIP's AHM-540 exam
Question #: 87
Topic #: 3
[All AHM-540 Questions]

The paragraph below contains two pairs of terms or phrases enclosed in parentheses. Determine which term or phrase in each pair correctly completes the paragraph. Then select the answer choice containing the terms or phrases that you have chosen.

Due to competitive pressures and consumer demand, many health plans now offer direct access or open access products. Under a direct access product, a member is (required / not required) to select a primary care provider (PCP), and is (required / not required) to obtain a referral from a PCP or the health plan before visiting a network specialist.

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Suggested Answer: B

by Tomas at May 10, 2024, 11:30 AM

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Jesse
8 months ago
Yep, that's how it works!
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Maryanne
8 months ago
I think it's "not required / not required."
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In
9 months ago
Wait, are you sure about that? Sounds too good to be true.
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Mabelle
9 months ago
Totally agree, it's all about flexibility.
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Reid
9 months ago
Direct access means no PCP needed!
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Valda
9 months ago
I’m not entirely sure, but I feel like both terms should be "not required" for direct access. I might go with D, but I need to double-check.
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Haley
10 months ago
I practiced a question like this, and I believe direct access means you can go straight to a specialist without a referral. So, I think it’s D.
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Ellen
10 months ago
I’m a bit confused about the referral part. I feel like in some similar questions, it was required to get a referral. Maybe option B?
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Hailey
10 months ago
I think I remember that with direct access products, members are not required to choose a PCP. So, I’m leaning towards option D.
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Dannette
10 months ago
I feel pretty good about this question. The information in the paragraph is clear, and I just need to carefully match the right terms to the blanks.
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Heidy
10 months ago
This is a tricky one. I'm going to make my best guess, but I'm not totally confident in my answer.
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Jestine
10 months ago
Okay, I think I've got it. The key is understanding that "direct access" means you don't need a referral to see a specialist. So the correct answer must be the one where the member is not required to get a referral.
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Lorenza
10 months ago
This question seems pretty straightforward. I'll carefully read through the paragraph and options to determine the correct terms that complete the sentences.
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Deane
10 months ago
Hmm, I'm a little unsure about this one. I'll need to re-read the paragraph a few times to make sure I understand the differences between "required" and "not required" for selecting a PCP and getting a referral.
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Rossana
10 months ago
Okay, let's think this through. I'm leaning towards either the Process Automation or Flow Builder options, as those seem like the most flexible ways to control the editability of records based on their stage. I'll need to review the specifics of each approach to decide which one is the best fit.
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Noel
10 months ago
This seems straightforward. The message points to network or storage issues, so I'll go with the options that address those areas. Shouldn't be too difficult to narrow it down.
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Catherin
10 months ago
Option C sounds right to me - MP-BGP is the protocol used between the border leaf and the external router for the L3Out connection.
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Nelida
10 months ago
If I recall correctly, the destructor should be called for each created object, so C could be correct too.
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Caitlin
1 year ago
I'm going with B) required / not required. Sounds like a pretty sweet deal - no PCP required, but you still get in-network coverage. Where do I sign up?
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Angelo
1 year ago
Definitely a convenient option for those who prefer direct access to specialists.
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France
1 year ago
I agree, no need for a PCP but still get to see a specialist without a referral.
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Janae
1 year ago
I think B) required / not required is the right choice. It does sound like a good deal.
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Marvel
1 year ago
B) is the way to go. It's like getting a free pass to see any specialist you want, without having to check in with your mom - I mean, PCP first.
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Joaquin
1 year ago
Direct access products definitely make it easier to get the care you need without any extra steps.
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Wilford
1 year ago
I prefer not being required to select a primary care provider, it gives me more flexibility.
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Delsie
1 year ago
I agree, having the freedom to see any specialist without a referral is convenient.
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Beckie
1 year ago
Definitely B) required / not required. I've had experience with these types of plans, and that's exactly how they work. No need to overthink it.
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Bo
1 year ago
I don't know, this question is giving me a headache. Why can't they just ask something simple like 'what's the square root of 64'? At least that I'd know for sure.
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Shawnta
1 year ago
No, I believe it's A) required / required.
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Valentin
1 year ago
B) required / not required
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Bobbie
1 year ago
I think it's A) required / required.
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Darnell
1 year ago
A) required / required
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Tawny
1 year ago
B) required / not required makes the most sense to me. Seems like a direct access product would not require a PCP selection or referral, which is what the question is describing.
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Victor
1 year ago
But wouldn't it make sense for a member to be required to select a PCP and not required to obtain a referral? So, I still think A) is the correct answer.
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Joanna
1 year ago
I disagree, I believe the answer is B) required / not required.
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Victor
1 year ago
I think the answer is A) required / required.
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Erin
1 year ago
But wouldn't it make sense for a member to be required to select a PCP and not required to obtain a referral? That's why I think A) is the correct answer.
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Quinn
1 year ago
I disagree, I believe the answer is B) required / not required.
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Erin
1 year ago
I think the answer is A) required / required.
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