Exam Code: AHM-540
Exam Questions: 165
Medical Management (AHM540)
Updated: 24 Nov, 2025
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Question 1

Benchmarking is a quality improvement strategy used by some health plans. With regard to benchmarking, it is correct to say that 

Options :
Answer: D

Question 2

Health plans arrange for the delivery of various levels of healthcare, including

1. Emergency care

2. Urgent care

3. Primary care delivered in a provider’s office

In a ranking of these levels of care according to cost, beginning with the least expensive level of

care and ending with the most expensive level of care, the correct order would be 

Options :
Answer: D

Question 3

For this question, if answer choices (A) through (C) are all correct, select answer choice (D). Otherwise, select the one correct answer choice. The QAPI (Quality Assessment Performance Improvement Program) is a Centers for Medicaid and Medicare Services (CMS) initiative designed to strengthen health plans’ efforts to protect and improve the health and satisfaction of Medicare beneficiaries. QAPI quality assessment standards apply to

Options :
Answer: D

Question 4

A health plan’s coverage policies are linked to its purchaser contracts. The following statement(s) can correctly be made about the purchaser contract and coverage decisions: 1. In case of conflict between the purchaser contract and a health plan’s medical policy or benefits administration policy, the contract takes precedence 2. Purchaser contracts commonly exclude custodial care from their coverage of services and supplies 3. All of the criteria for coverage decisions must be included in the purchaser contract  

Options :
Answer: B

Question 5

Comorbidity can have a significant impact on the effective implementation of disease management programs. Comorbidity can correctly be defined as the

Options :
Answer: D

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