Free AHM-250 Exam Braindumps

- (Topic 3)
George was covered by a united health care insurance policy. This policy says that Geroge has to pay $300 out of pocket for the medical expenses in that year before united health care will start to reimburse the medical expense incurred for George. What is the term used to call the out of pocket payment made by George.

1. A. Co-payment
2. B. Deductible
3. C. Coinsurance
4. D. None of the above

Correct Answer: B

- (Topic 3)
The Oriole MCO uses a typical diagnosis-related groups (DRGs) payment method to reimburse the Isle Hospital for its treatment of Oriole members. Under the DRG payment method, whenever an Oriole member is hospitalized at Isle, Oriole pays Isle

1. A. an amount based on the weighted value of each medical procedure or service that Isle provides, and the weighted value is determined by the appropriate current procedural terminology (CPT) code for the procedure or service
2. B. a fixed rate based on average expected use of hospital resources in a given geographical area for that DRG
3. C. a retrospective reimbursement based on the actual costs of the Oriole member's hospitalization
4. D. a specific negotiated amount for each day the Oriole member is hospitalized

Correct Answer: B

- (Topic 3)
Ancillary services are

1. A. General medical care that is provided directly to a patient without referral from another physician
2. B. Also known as secondary care (Medical care that is delivered by specialist)
3. C. Supplemental services needed as part of providing other care
4. D. Outpatient services provided by a hospital or other qualified ambulatory care facility which require inpatient stay

Correct Answer: C

- (Topic 1)
In order to cover some of the gap between FFS Medicare coverage and the actual cost of services, beneficiaries often rely on Medicare supplements. Which of the following statements about Medicare supplements is correct?

1. A. The initial ten (A-J) Medigap policies offer a basic benefit package that includes coverage for Medicare Part A and Medicare Part B coinsurance.
2. B. Each insurance company selling Medigap must sell all the different Medigap policies.
3. C. Medicare SELECT is a Medicare supplement that uses a preferred provider organization (PPO) to supplement Medicare Part A coverage.
4. D. Medigap benefits vary by plan type (A through L), and are not uniform nationally.

Correct Answer: A

- (Topic 3)
The following statements are about the accessibility of healthcare coverage and medical care in the United States. Select the answer choice that contains the correct statement.

1. A. A person’s employment status as a full-time employee guarantees that person access to healthcare coverage.
2. B. Most people who have healthcare coverage are covered under an individual insurance policy rather than a group insurance plan.
3. C. The percentage of the population without healthcare coverage is evenly distributed throughout the United States.
4. D. Hospital closings have occurred disproportionately in rural areas and inner cities and have reduced access to healthcare in these areas.

Correct Answer: D