Healthcare Management: An Introduction (AHM-250) Free Practice Test

Question 1

The following statements are about the make-up and function of an HMO's board of directors.
Select the answer choice that contains the correct statement.

A. An HMO's board of directors is not responsible for supervising the performance of its officers and outside advisors.

B. The board of directors of a not-for-profit HMO is exempt from liability for its actions.

C. A primary function of the board of directors is to approve and evaluate the organization's operational policies and procedures.

D. The make-up of an HMO's board of directors is prescribed by state regulations and does not vary according to whether the plan is a for-profit or not-for-profit plan.

Correct Answer: C

Question 2

Which of the following people would be considered part of the individual market segment?

A. John is eligible for Medicare.

B. Julie has coverage through an employer group.

C. James works for an employer that does not offer health coverage.

D. Jenny is eligible for Medicaid.

Correct Answer: C

Question 3

Appropriateness of treatment provided is determined by developing criteria that if unmet will prompt further investigation of a claim which are also called:

A. Codes

B. Lists

C. Checks

D. Edits

Correct Answer: D

Question 4

Combined system of preventive, diagnostic and therapeutic measures that focuses on management of specific chronic illness or medical conditions are:

A. Disease management

B. Utilization Review

C. Case Management

D. Demand Management

Correct Answer: C

Question 5

Medicare Part C can be delivered by the following Medicare Advantage plans:

A. HMO, PPO (local or regional), POS, or MSA.

B. HMO, HSA, PPO (local or regional), PFFS or MSA.

C. HCCP, HMO, PPO (local or regional), PFFS or MS

D. CCPs, PFFS or MSA.

Correct Answer: D

Question 6

Which of the following statements about Family and Medical Leave Act (FMLA) is WRONG?

A. Employers that have > 50 employees need to comply

B. Protects people faced with birth/adoption or seriously ill family members

C. Employers need to maintain the coverage of group health insurance during this period

D. Employees can take upto 12 weeks of unpaid leave in a 36 month period

Correct Answer: D

Question 7

Which of the choices below contains the four tools used by marketers that make up the 'promotion mix'?

A. Admissions, personal selling, sales promotion, and publicity.

B. Advertising, personal selling, sales promotion, and publicity.

C. Advertising, personal selling, sales promotion, and privacy.

D. Advertising, price, sales promotion, and publicity.

Correct Answer: B

Question 8

In order to be more effective, changes to structure and processes must be carefully

A. Planned

B. Implemented

C. Documented

D. Evaluated

E. All the above

Correct Answer: E

Question 9

Parable Healthcare Providers, a health plan, recently segmented the market for a new healthcare service. Parable began the process by dividing the healthcare market into two broad categories: non-group and group. Next, Parable further segmented the non-gr

A. demographic segmentation

B. channel segmentation

C. geographic segmentation

D. product segmentation

Correct Answer: A

Question 10

Dr. Julia Phram is a cardiologist under contract to Holcomb HMO, Inc., a typical closed-panel plan. The following statements are about this situation. Select the answer choice containing the correct statement.

A. Holcomb HMO plan members may self-refer to Dr. Phram at full benefits without first obtaining a referral from their PCPs.

B. Dr. Phram is either an employee of Holcomb HMO or belongs to a group of physicians that has contracted with Holcomb HMO

C. Any physician who meets Holcomb's standards of care is eligible to contract with Holcomb HMO as a provider.

D. All members of Holcomb HMO must select Dr. Phram as their primary care physician (PCP).

Correct Answer: D

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AHIP Healthcare Management: An Introduction (AHM-250) Free Practice Test