AHM-250 Free Practice Test

- (Topic 1)
Historically most HMOs have been

1. A. Closed-access HMO
2. B. Closed-panel HMO
3. C. Open-access HMO
4. D. Open-panel HMO

Correct Answer: B

- (Topic 2)
More procedures or services may be fully covered within the PPO network than those out of network.

1. A. True
2. B. False

Correct Answer: A

- (Topic 3)
The Hill Health Plan designed a set of benefits that it packaged in the form of a PPO product. Hill then established a pricing structure that allowed its product to compete in the small group market, and it developed advertising designed to inform potential

1. A. A decision as to which exclusions or limitations would apply for this product.
2. B. A decision as to how to establish the network of participating providers for this product
3. C. A determination of the level at which this product would cover out-of-network services.
4. D. All of the above.

Correct Answer: D

- (Topic 2)
Natalie Chan is a member of the Ultra Health Plan, a health plan. Whenever she needs nonemergency medical care, she sees Dr. David Craig, an internist. Ms. Chan cannot self- refer to a specialist, so she saw Dr. Craig when she experienced headaches. Dr. Cr

1. A. Within Ultra's system, M
2. B. Chan received primary care from both D
3. C. Craig and D
4. D. Lee
5. E. Ultra's system allows its members open access to all of Ultra's participating providers.
6. F. Within Ultra's system, D
7. G. Craig serves as a coordinator of care or gatekeeper for the medical services that M
8. H. Chan receives.
9. I. Ultra's network of providers includes D
10. J. Craig and D
11. K. Lee but not Arrow Hospital

Correct Answer: C

- (Topic 3)
What is a mathematical process that involves using a number of hypothetical situations that, in total, will reasonably reflect an event that will occur in real life

1. A. Forecasting
2. B. Modelling
3. C. Both a and b
4. D. None of the above

Correct Answer: B