AHM-250 Free Practice Test

- (Topic 2)
The Acme HMO recruits and contracts directly with a wide range of physicians—both PCPs and specialists—in its geographic area on a non-exclusive basis. There is no separate legal entity that represents and negotiates the contracts for the physicians. The

1. A. an independent practice association (IPA) model HMO
2. B. a staff model HMO
3. C. a direct contract model HMO
4. D. a group model HMO

Correct Answer: C

- (Topic 1)
Eleanor Giambi is covered by a typical 24-hour managed care program. One characteristic of this program is that it:

1. A. Provides M
2. B. Giambi with healthcare coverage for any illness or injury, but only if the cause of the illness or injury is work-related.
3. C. Combines the group health plan and disability plan offered by M
4. D. Giambi's employer with workers' compensation coverage.
5. E. Requires M
6. F. Giambi and her employer to each pay half of the cost of this coverage.
7. G. Requires M
8. H. Giambi to pay specified deductibles and copayments before receiving benefits under this program for any illness or injury.

Correct Answer: B

- (Topic 3)
Which of the following statements is true?

1. A. A declining economy can lead to lower healthcare costs as a result of an older population with greater healthcare needs.
2. B. A larger patient population increases pressure on the health plan to offer larger panels.
3. C. Provider networks are not affected by the federal and state laws that apply to health plans
4. D. Network management standards established by independent accrediting organizations have no influence on health plan network design.

Correct Answer: B

- (Topic 3)
When the Knoll Company purchased group health coverage from the Castle Health Maintenance Organization (HMO), the agreement between the two parties specified that the plan would be a typical fully funded plan. Because Knoll had been covered under a previous

1. A. 230
2. B. 270
3. C. 220
4. D. 180

Correct Answer: C

- (Topic 3)
The following statements describe individuals who are applying for individual health insurance coverage:
Six months ago, Wilbur Lee lost his health insurance coverage due to a reduction in work hours and has exhausted his coverage under COBRA. Mr. Lee has

1. A. both M
2. B. Lee and M
3. C. Beeker
4. D. M
5. E. Lee only
6. F. M
7. G. Beeker only
8. H. neither M
9. I. Lee nor M
10. J. Beeker

Correct Answer: A