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Questions came word by
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AHM-250 Questions and Answers

Question # 1

The Ark Health Plan, is currently recruiting providers in preparation for its expansion into a new service area. A recruiter for Ark has been meeting with Dr. Nan Shea, a pediatrician who practices in Ark's new service area, in order to convince her to be

A.

Credentialing

B.

Accreditation

C.

A sentinel event

D.

A screening program

Question # 2

Lansdale Healthcare, a health plan, offers comprehensive healthcare coverage to its members through a network of physicians, hospitals, and other service providers. Plan members who use in-network services pay a copayment for these services. The copayment

A.

specified dollar amount charge that a plan member must pay out-of-pocket for a specified medical service at the time the service is rendered

B.

percentage of the fees for medical services that a plan member must pay after Magellan has paid its share of the costs of those services

C.

flat amount that a plan member must pay each year before Magellan will make any benefit payments on behalf of the plan member

D.

specified payment for services that was negotiated between the provider and Magellan

Question # 3

Medicare is the federal government program established under Title XVIII of the Social Security Act of 1965 to provide hospital, medical and other covered benefits to elderly and disabled persons. Medicare is available for:

A.

Persons age 63 or older.

B.

Persons with qualifying disabilities (over the age of 63)

C.

Persons with end-stage renal disease (ESRD)

D.

Low income individuals

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