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Score Higher on Verified AHM-540 | Medical Management Exam Questions with Answers

Are you ready to take the Medical Management? To learn AHM-540 exam questions, smart security solutions, and move IT forward, you need the AHIP AHM-540 Certification. Whether you're making security rules for the whole company or working on hard problems, AHIP makes sure you're ready for anything. Crack4sure offers study materials and practice problems covering the exam syllabus for AHIP Courses, including Medical Management. Check for daily deals to get products that can help you pass.

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  • Exam Name: Medical Management
  • Last Update: 04-Dec-2025
  • Questions and Answers: 163
  • Single Choice: 163 Q&A's

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AHM-540 Questions and Answers

Question # 1

Health plan performance measures include structure measures, process measures, and outcome measures. The following statements are about the characteristics of these three types of performance measures. Three of the statements are true and one is false. Select the answer choice containing the FALSE statement.

A.

The most widely used structure measures relate to physician education and training.

B.

One advantage of structure measures over process measures is that structures are often linked directly to healthcare outcomes.

C.

Process measures are useful in identifying underuse, overuse, and inappropriate use of services.

D.

One disadvantage of outcome measures is that they can be influenced by factors outside the control of the health plan.

Question # 2

The following statements are about risk management for case management. Three of the statements are true and one is false. Select the answer choice containing the FALSE statement.

A.

The use of a signed consent authorization form is consistent with accrediting agency standards for patient privacy and confidentiality of medical information.

B.

Case management that is initiated after a member has incurred substantial medical expenses is more likely to be viewed as a tool to cut costs rather than to improve outcomes.

C.

Health plan documents indicating that any case management delegates are separate, independent entities may reduce an health plan's exposure to risk.

D.

A case management file cannot be used to support the health plan's position in the event of a lawsuit.

Question # 3

The Garnet Health Plan uses provider profiling to measure and improve provider performance. Provider profiling most likely allows Garnet to

A.

evaluate all providers without considering differences in risk

B.

focus on specific clinical decisions of Garnet’s providers rather than on patterns of care

C.

identify the outliers and high-value providers in its provider network

D.

measure the effectiveness, but not the efficiency, of Garnet’s providers

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