Free AHM-250 Exam Braindumps

- (Topic 2)
Pharmacy benefit management (PBM) companies typically interact with physicians and pharmacists by performing such clinical services as physician profiling. Physician profiling from a PBM's point of view involves

1. A. ascertaining that physicians in the plan have the necessary and appropriate credentials to prescribe medications
2. B. compiling data on physician prescribing patterns and comparing physicians' actual prescribing patterns to expected patterns within select drug categories
3. C. monitoring patient-specific drug problems through concurrent and retrospective review
4. D. establishing protocols that require physicians to obtain certification of medical necessity prior to drug dispensing

Correct Answer: B

- (Topic 1)
Bill Clinton is a member of Lewinsky's PBM plan which has a three-tier copayment structure. Bill fell ill and his doctor prescribed him AAA, a brand-name drug which was included in the Lewinsky's formulary; BBB, a non-formulary drug; and CCC, a generic dr

1. A. CCC, AAA, BBB
2. B. BBB, CCC, AAA
3. C. BBB, AAA, CCC
4. D. CCC, BBB, AAA

Correct Answer: A

- (Topic 1)
Greentree Medical, a health plan, is currently recruiting PCPs in preparation for its expansion into a new service area. Abigail Davis, a recruiter for Greentree, has been meeting with Melissa Cortelyou, M.D., in an effort to recruit her as a PCP in Green

1. A. Greentree is prevented by law from offering a contract to D
2. B. Cortelyou until the credentialing process is complete
3. C. any contract signed by D
4. D. Cortelyou should include a clause requiring the successful completion of the credentialing process within a defined time frame in order for the contract to be effective
5. E. Greentree must offer a standard contract to D
6. F. Cortelyou, without regard to the outcome of the credentialing process
7. G. Greentree will abandon the credentialing process now that D
8. H. Cortelyou has agreed to participate in Greentree's network

Correct Answer: B

- (Topic 1)
In order to compensate for lost revenue resulting from services provided free or at a significantly reduced cost to other patients, many healthcare providers spread these unreimbursed costs to paying patients or third-party payors. This practice is known

1. A. dual choice
2. B. cost shifting
3. C. accreditation
4. D. defensive medicine

Correct Answer: B

- (Topic 3)
The agreement by two or more independent competitors on the prices or fees that they will charge for services is known as:

1. A. Tying arrangements
2. B. Price fixing
3. C. Horizontal group boycott
4. D. Horizontal division of markets

Correct Answer: B