QUESTION: 93

In order to help review its institutional utilization rates, the Sahalee Medical Group, a health plan, uses the standard formula to calculate hospital bed days per 1,000 plan members for the month to date (MTD). On April 20, Sahalee used the following inf

67
274
365
1,000

Answer(s): B

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QUESTION: 94

In order to measure the expenses of institutional utilization, Holt Healthcare Group uses the standard formula to calculate hospital bed days per 1,000 plan members per year. On October 23, Holt used the following information to calculate the bed days per

278
397
403
920

Answer(s): B

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QUESTION: 95

In preparation for its expansion into a new service area, the Regal MCO is meeting with Dr. Nancy Buhner, a cardiologist who practices in Regal's new service area, in order to convince her to become one of the plan's participating providers. As part of the

ensure that Dr. Buhner complies with all of the provisions of the Ethics in Patient Referrals Act
learn whether Dr. Buhner is a licensed medical practitioner
confirm Dr. Buhner's membership in the National Committee for Quality Assurance (NCQA)
learn whether Dr. Buhner has had a medical malpractice claim filed or other disciplinary actions taken against her

Answer(s): D

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QUESTION: 96

In response to the demand for a method of assessing outcomes, accrediting organizations and other government and commercial groups have developed quantitative measures of quality that consumers, purchasers, regulators, and others can use to compare health

quality standards
accreditation decisions
standards of care
performance measures

Answer(s): D

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Free AHM-250 Exam Braindumps (page: 25)

QUESTION: 93

QUESTION: 94

QUESTION: 95

QUESTION: 96

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