AHM-540 試験問題を無料オンラインアクセス

Determine whether the following statement is true or false:
The delegation of medical management functions to providers can occur without the transfer of financial risk.

• A.True
• B.False

The Riverside Health Plan is considering the following provider compensation options to use in its contracts with several provider groups and hospitals:
1.A discounted fee-for-service (DFFS) payment system
2.A case rate system
3.Capitation
If Riverside wants to use only those compensation methods that encourage the efficient use of resources, then the compensation method(s) that Riverside should consider for its new contracts include

• A.1 and 2 only
• B.3 only
• C.1, 2, and 3
• D.2 and 3 only

The following statements are about medical management considerations for dental care. Select the answer choice containing the correct statement.

• A.Dental care differs from medical care in that most dental care is provided by specialists.
• B.Dental preferred provider organizations (Dental PPOs) are subject to more regulation than are dental health maintenance organizations (DHMOs).
• C.Managed dental care organizations are regulated at the state rather than the federal level.
• D.Managed dental plans are accredited by the National Association of Dental Plans (NADP).

One method of transferring the information in electronic medical records (EMRs) is through a health information network (HIN). The following statements are about HINs. Three of the statements are true and one is false. Select the answer choice containing the FALSE statement.

• A.The use of a HIN typically increases a health plan's exposure to liability for poor care.
• B.A HIN may afford a health plan better measurements of outcomes and provider performance.
• C.Most HINs are Internet-based rather than built on proprietary computer networks.
• D.Currently, the majority of health plans do not have HINs that are capable of transferring medical records among their network providers.

Elaine Newman suffered an acute asthma attack and was taken to a hospital emergency department for treatment. Because Ms. Newman's condition had not improved enough following treatment to warrant immediate release, she was transferred to an observation care unit. Transferring Ms. Newman to the observation care unit most likely

• A.prevented Ms. Newman from receiving immediate attention for her condition
• B.allowed clinical staff an opportunity to determine whether Ms. Newman required hospitalization without actually admitting her
• C.gave Ms. Newman access to more effective and efficient treatment than she could have obtained from other providers in the same region
• D.resulted in unnecessarily expensive charges for treatment