성공으로 향하는 길에는 많은 방법과 방식이 있습니다.AHIP Certification AHM-250 시험을 패스하는 길에는 Pass4Test의  AHIP Certification AHM-250 덤프가 있습니다. Pass4Test의AHIP Certification AHM-250 덤프는 실제시험 출제방향에 초점을 두어 연구제작한 시험준비공부자료로서 높은 시험적중율과 시험패스율을 자랑합니다.국제적으로 승인해주는 IT자격증을 취득하시면 취직 혹은 승진이 쉬워집니다.

NO.1 Which of the following statements about the Title VII of the Civil Rights Act is WRONG?
A. Employers with more than 15 employees engaged in interstate commerce need to comply
B. Pregnancy Discrimination Act (an amendment to this act) requires health plans to provide
coverage during childbirth and related medical conditions on the same basis as they provide coverage
for other medical conditions
C. Allows HMOs to set different policies for people from different races, religions, sex or national
origin to safeguard their interests.
D. Protects all employees
Answer: C

NO.2 The Military Health System of the Department of Defense offers ongoing healthcare coverage
to military personnel and their families through the
A. Health Care Quality Improvement Program (HCQIP)
B. Health Plan Management System (HPMS)
C. TRICARE healthcare system
D. Health Care Prepayment Plan (HCPP)
Answer: C

NO.3 Bill the member for the balance of the fee above the maximum allowable amount under the fee
schedule reimbursement method
A. UCR fee
B. Capitation fee
C. Balance bill
D. Discounted fee-for-service
Answer: C

NO.4 The main purpose of the Health Plan Employer Data and Information Set (HEDIS) is to provide
A. expert consultation to end-users for solving specialized and complex healthcare problems through
the use of a knowledge-based computer system
B. a comprehensive accreditation for PPOs
C. measurements of plan performance and effectiveness that potential healthcare purchasers can use
to compare quality offered by different healthcare plans
D. a mathematical model that can predict future claim payments and premiums
Answer: C

NO.5 The Oriole MCO uses a typical diagnosis-related groups (DRGs) payment method to reimburse
the Isle Hospital for its treatment of Oriole members. Under the DRG payment method, whenever an
Oriole member is hospitalized at Isle, Oriole pays Isle
A. an amount based on the weighted value of each medical procedure or service that Isle provides,
and the weighted value is determined by the appropriate current procedural terminology (CPT) code
for the procedure or service
B. a fixed rate based on average expected use of hospital resources in a given geographical area for
that DRG
C. a retrospective reimbursement based on the actual costs of the Oriole member's hospitalization
D. a specific negotiated amount for each day the Oriole member is hospitalized
Answer: B

NO.6 Utilization management techniques that most HMOs use for hospital providers include:
A. Discharge planning
B. Case management
C. Co-payment for office visits
D. A & B
Answer: A,B

NO.7 Medicaid is a jointly funded federal and state program that provides hospital and medical
expense coverage to low-income individuals and certain aged and disabled individuals. One
characteristic of Medicaid is that
A. providers who care for Medicaid recipients must accept Medicaid payment as payment in full for
services rendered
B. Medicaid requires recipients to pay deductibles, copayments, and coinsurance amounts for all
services
C. Medicaid is always the primary payer of benefits
D. benefits offered by Medicaid programs are federally mandated and do not vary by state
Answer: A

NO.8 The measures used to evaluate healthcare quality are generally divided into three categories:
process, structure, and outcomes. An example of a process measure that can be used to evaluate a
health plan's performance is the:
A. Percentage of adult plan members who receive regular medical checkups.
B. Number of plan members contracting an infection in the hospital.
C. Percentage of board certified physicians within the health plan's network.
D. Number of hospital admissions for plan members with certain medical conditions.
Answer: A