We offer the latest AHM-540 practice test designed for free and effective online Medical Management (AHM540) certification preparation. It's a simulation of the real AHM-540 exam experience, built to help you understand the structure, complexity, and topics you'll face on exam day.
Michelle Durden, who is enrolled in a dental health maintenance organizations (DHMO) offered by her employer, is due for a routine dental examination. If the plan is typical of most DHMOs, then Ms. Durden
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
One true statement about state regulation of case management activities is that the majority of states
Helena Ray, a member of the Harbrace Health Plan, suffers from migraine headaches. To treat
Ms. Ray’s condition, her physician has prescribed Upzil, a medication that has Food and Drug
Administration (FDA) approval only for the treatment of depression. Upzil has not been tested for
safety or effectiveness in the treatment of migraine headache. Although Harbrace’s medical policy
for migraine headache does not include coverage of Upzil, Harbrace has agreed to provide extracontractual
coverage of Upzil for Ms. Ray.
In this situation, the prescribing of Upzil for Ms. Ray’s headaches is an example of
Demetrius Farrell, age 82, is suffering from a terminal illness and has consulted his health plan
about the care options available to him. In order to avoid unwanted, futile interventions, Mr. Farrell
signed an advance directive that indicates the types of end-of-life medical treatment he wants to
receive. His family is to use this document as a guide should Mr. Farrell become incapacitated.
For this question, if answer choices (A) through (C) are all correct, select answer choice (D).
Otherwise, select the one correct answer choice.
Decisions regarding Mr. Farrell’s end-of-life care are legally the right and responsibility of
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