Printable PDFAHIP AHM-540 Exam Questions & Answers
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Vendor: AHIP
Exam Code: AHM-540
Exam Name: Medical Management
Certification Provider: AHIP
Total Questions: 163 Q&A
Updated on: Jun 30, 2026
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AHM-540 Online Practice Questions and Answers
Increased demands for performance information have resulted in the development of various health plan report cards. With respect to most of the report cards currently available, it is correct to say
A. that they are focused primarily on health maintenance organization (HMO) plans
B. that they are based on data collected for the Health Plan Employer Data and Information Set (HEDIS)
3.0
C. that they are used to rank the performance of various health plans
D. all of the above
The paragraph below contains two pairs of terms or phrases enclosed in parentheses. Select the term or phrase in each pair that correctly completes the paragraph. Then select the answer choice containing the two terms or phrases you have chosen.
TRICARE enrollees have the right to challenge authorization and coverage decisions. Such challenges are referred to as (appeals / grievances) and are typically handled by the (TRICARE contractor / Area Field Office).
A. appeals / TRICARE contractor
B. appeals / Area Field Office
C. grievances / TRICARE contractor
D. grievances / Area Field Office
Determine whether the following statement is true or false:
The key to successfully managing the quality and cost-effectiveness of healthcare services for Medicaid enrollees is to merge Medicaid recipients into existing plans.
A. True
B. False
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