Free AHM-250 Exam Braindumps

- (Topic 2)
The Advantage Health Plan recently added the following features to its member services program:
1. IVR
2. Active member outreach program
3. Advantage's member services staffing needs are likely to increase as a result of

1. A. 1
2. B. 2
3. C. 1 & 2
4. D. Neither 1 nor 2

Correct Answer: B

- (Topic 2)
One ethical principle in managed care is the principle of justice/equity, which specifically holds that MCOs and their providers have a duty to

1. A. treat each member in a manner that respects his or her own goals and values
2. B. allocate resources in a way that fairly distributes benefits and burdens among the members
3. C. present information honestly to their members and to honor commitments to their members
4. D. make sure they do not harm their members

Correct Answer: B

- (Topic 1)
An exclusive provider organization (EPO) operates much like a PPO. However, one difference between an EPO and a PPO is that an EPO

1. A. Is regulated under federal HMO legislation
2. B. Generally provides no benefits for out-of-network care
3. C. Has no provider network of physicians
4. D. Is not subject to state insurance laws

Correct Answer: B

- (Topic 1)
An HMO that combines characteristics of two or more HMO models is sometimes referred to as a

1. A. Network model HMO
2. B. Group model HMO
3. C. Staff model HMO
4. D. Mixed model HMO

Correct Answer: D

- (Topic 3)
Renewal underwriting involves a reevaluation of

1. A. The group’s experience
2. B. Level of participation in the health plan
3. C. Both A and B
4. D. None of the Above

Correct Answer: C