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AHIP AHM-540 Exam
- Topic 1: Identify how and why a delegation is used in medical management/ Quality management methods?measurement and improvements
- Topic 2: Recognize how medical management is used to deliver Medicare and Medicaid services/ Explore strategies for managing complex individual cases
- Topic 3: Understand role of medical management in health insurance provider organizations/ Recognize the importance of preventive care and self-care programs
- Topic 4: Examine the role of medical management in providing pharmacy services/ Learn how medical management is used in different types of care
- Topic 5: Understand disease management?its purpose, processes, and programs
Free AHIP AHM-540 Exam Actual Questions
The questions for AHM-540 were last updated On Apr. 04, 2024
The paragraph below contains two pairs of terms or phrases enclosed in parentheses. Select the term or phrase in each pair that correctly completes the paragraph. Then select the answer choice containing the two terms or phrases you have chosen.
TRICARE enrollees have the right to challenge authorization and coverage decisions. Such challenges are referred to as (appeals / grievances) and are typically handled by the (TRICARE contractor / Area Field Office).
Serena Wilson, a registered nurse, is employed at a TRICARE Service Center (TSC) located at a military installation. Ms. Wilson serves as a primary point of contact between enrollees and the TRICARE system and answers enrollees' questions about plan options, eligibility, provider selection, and claims. This information indicates that Ms. Wilson serves as a
Occasionally, employers combine workers' compensation, group healthcare, and disability programs into an integrated product known as 24-hour coverage. One true statement about 24hour coverage is that it typically
CMS has developed two prototype programs---Programs of All-inclusive Care for the Elderly (PACE) and the Social Health Maintenance Organization (SHMO) demonstration project---to deliver healthcare services to Medicare beneficiaries. From the answer choices below, select the response that correctly identifies the features of these programs.
The delivery of quality, cost-effective healthcare is a primary goal of both group healthcare and workers' compensation programs. One difference between group healthcare and workers' compensation is that workers' compensation
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