AHM-250 AHIP Exam Questions and Free Practice Test

Question 13

- (Topic 1)
From the following answer choices, choose the description of the ethical principle that best corresponds to the term Autonomy

A. Health plans and their providers are obligated not to harm their members

B. Health plans and their providers should treat each member in a manner that respects the member's goals and values, and they also have a duty to promote the good of the members as a group

C. Health plans and their providers should allocate resources in a way that fairly distributes benefits and burdens among the members

D. Health plans and their providers have a duty to respect the right of their members to make decisions about the course of their lives

Correct Answer:D

Question 14

- (Topic 2)
One HMO model can be described as an extension of a group model HMO because it contracts with multiple group practices, rather than with a single group practice. This HMO model is known as the

A. staff model HMO

B. IPA model HMO

C. direct contract model HMO

D. network model HMO

Correct Answer:D

Question 15

- (Topic 3)
Which of the following is an example of physician only model of operational integration?

A. Consolidated medical group

B. Integrated Delivery System

C. Medical Foundation

D. Both B & C

Correct Answer:A

Question 16

- (Topic 3)
Common characteristics of POS products are

A. Lack of Freedom of choice

B. Absence of Primary care physician

C. Cost-cutting efforts and the structure of coverage

D. All of the above

Correct Answer:C

Question 17

- (Topic 2)
The Cleopatra Group, a third-party administrator (TPA), has entered into a TPA agreement with the Alexander MCO with regard to the administration of a particular health plan. This agreement complies with all of the provisions of the NAIC TPA Model Law. On

A. hold all funds it receives on behalf of Alexander in trust

B. assume full responsibility for determining the claim payment procedures for the plan

C. assume full responsibility for ensuring that the health plan is administered properly

D. obtain from the federal government a certificate of authority designating the Cleopatra Group as a TPA

Correct Answer:A

Question 18

- (Topic 1)
From the following choices, choose the definition that best matches the term Screening

A. A technique used to educate plan members on how to distinguish between minor problems and serious conditions and effectively treat minor problems themselves

B. A technique used to determine if a health condition is present even if a member has not experienced symptoms of the problem

C. A technique in which information about a plan member's health status, personal and family health history, and health-related behaviors is used to predict the member's likelihood of experiencing specific illnesses or injuries

D. A technique used to evaluate the medical necessity, appropriateness, and cost- effectiveness of healthcare services for a given patient

Correct Answer:B

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