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 AHM-540 Dumps with Practice Exam Questions Answers

Questions: 163 questions

Last Update: Jun 10, 2024

AHIP Certification Exam AHM-540 has been designed to measure your skills in handling the technical tasks mentioned in the certification syllabus

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AHM-540 Questions and Answers

Question # 1

The following statements are about the use of provider profiling for pharmacy benefits. Three of the statements are true and one is false. Select the answer choice containing the FALSE statement.

A.

Health plans typically use provider profiles to improve the quality of care associated with the use of prescription drugs.

B.

Provider profiles identify prescribing patterns that fall outside normal ranges.

C.

Health plans can motivate providers to change their prescribing patterns by sharing profile information with plan members and the general public.

D.

Provider profiles are effective in modifying individual prescribing patterns, but they have little effect on group prescribing patterns.

Question # 2

Home healthcare encompasses a wide variety of medical, social, and support services delivered at the homes of patients who are disabled, chronically ill, or terminally ill. The time period(s) when health plans typically use home healthcare include

1. The period prior to a hospital admission

2. The period following discharge from a hospital

A.

Both 1 and 2

B.

1 only

C.

2 only

D.

Neither 1 nor 2

Question # 3

To improve members’ abilities to make appropriate care decisions about specific medical problems, some health plans use a form of decision support known as telephone triage programs. The following statements are about telephone triage programs. Select the answer choice containing the correct statement.

A.

The primary role of telephone triage clinical staff is to diagnose the caller’s condition and give medical advice.

B.

Quality management (QM) for telephone triage programs typically focuses on the clinical information provided rather than on the quality of service.

C.

Currently, none of the major accrediting agencies offers an accreditation program specifically for telephone triage programs.

D.

A telephone triage program may also include a self-care component.

Question # 4

Performance variance can be classified as either common cause variance or special cause variance. The following statement(s) can correctly be made about special cause variance:

1. Inadequate staffing levels, employee errors, and equipment malfunctions are examples of special cause variance

2. Special cause variance is typically more difficult to detect and correct than is common cause variance

A.

Both 1 and 2

B.

1 only

C.

2 only

D.

Neither 1 nor 2

Question # 5

For this question, if answer choices (a) through (c) are all correct, select answer choice (d). Otherwise, select the one correct answer choice.

Well-crafted clinical practice guidelines (CPGs) can benefit healthcare delivery processes and outcomes by

A.

providing a framework for care while also allowing for patient-specific variations, based on physician judgment

B.

serving as a basis for evaluating whether providers are practicing in accordance with accepted standards

C.

focusing on the prevention or early detection of a particular condition

D.

all of the above