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AHIP AHM-250: Healthcare Management: An Introduction

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Question 1

- (Topic 1)
Bart Vereen is insured by both a traditional indemnity health insurance plan, which is his primary plan, and a managed care plan. Both plans have a typical coordination of benefits (COB) provision, but neither plan has a nonduplication of benefits provision

A. 380

B. 130

C. 550

Correct Answer:A

Question 2

- (Topic 1)
In assessing the potential degree of risk represented by a proposed insured, a health underwriter considers the factor of anti selection. Anti selection can correctly be defined as the

A. inability of a proposed insured to share with the insurer the financial risks of healthcare coverage

B. possibility that a proposed insured will profit from an illness by receiving benefits that exceed the total amount of his or her eligible medical expenses

C. inability of a proposed insured to provide sufficient evidence that proves he or she is an insurable risk

D. tendency of people who have a greater-than-average likelihood of loss to apply for or continue insurance protection to a greater extent than people who have an average or less than average likelihood of the same loss

Correct Answer:D

Question 3

- (Topic 3)
One among the following is a reason that limit access to health care for US people.

A. Life Style of the people

B. Concentration of physicians in highly populated areas.

C. Advancement in information technology

Correct Answer:B

Question 4

- (Topic 1)
All CDHP products provide federal tax advantages while allowing consumers to save money for their healthcare.

A. True

B. False

Correct Answer:A

Question 5

- (Topic 3)
Which out of the three is accomplished through precertification?

A. Concurrent review

B. Retrospective review

C. Prospective review

Correct Answer:C

Question 6

- (Topic 3)
The situation wherein two hospitals agree to each refuse to contract with a health plan until the health plan cease contract negotiations with a competing hospital is known as

A. Horizontal division of markets

B. Tying arrangements

C. Horizontal group boycott

D. Price fixing

Correct Answer:C

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