AHM-250 Free Practice Test

- (Topic 1)
By definition, a health plan's network refers to the

1. A. organizations and individuals involved in the consumption of healthcare provided by the plan
2. B. relative accessibility of the plan's providers to the plan's participants
3. C. group of physicians, hospitals, and other medical care providers with whom the plan has contracted to deliver medical services to its members
4. D. integration of the plan's participants with the plan's providers

Correct Answer: C

- (Topic 1)
From the following answer choices, choose the description of the ethical principle that best corresponds to the term Beneficence

1. A. Health plans and their providers are obligated not to harm their members
2. B. Health plans and their providers should treat each member in a manner that respects the member's goals and values, and they also have a duty to promote the good of the members as a group
3. C. Health plans and their providers should allocate resources in a way that fairly distributes benefits and burdens among the members
4. D. Health plans and their providers have a duty to respect the right of their members to make decisions about the course of their lives

Correct Answer: B

- (Topic 1)
In large health plans, management functions such as provider recruiting, credentialing, contracting, provider service, and performance management for providers are typically the responsibility of the

1. A. chief executive officer (CEO)
2. B. network management director
3. C. board of directors
4. D. director of operations

Correct Answer: B

- (Topic 3)
Traditional Medicare includes two parts: Medicare Part A and Medicare Part B. With regard to the ways these parts differ from each other, it is correct to say that Medicare Part A

1. A. provides benefits for physicians' professional services, whereas Medicare Part B provides basic hospitalization insurance
2. B. is financed through premiums paid by covered persons and from the federal government's general tax revenues, whereas Medicare Part B is funded primarily through a payroll tax imposed on employers and workers
3. C. provides 100% coverage for eligible medical expenses, whereas Medicare Part B includes annual deductible and coinsurance provisions
4. D. is provided automatically to most eligible persons, whereas Medicare Part B is a voluntary program

Correct Answer: D

- (Topic 3)
Which of the following people would be considered part of the individual market segment?

1. A. John is eligible for Medicare.
2. B. Julie has coverage through an employer group.
3. C. James works for an employer that does not offer health coverage.
4. D. Jenny is eligible for Medicaid.

Correct Answer: C