QUESTION: 97

The Omni Health Plan is interested in expanding the specialty services it offers to its plan members and is considering contracting with the following providers of specialty services:

The Apex Company, a managed vision care organization (MVCO) The Baxter Managed Behavioral Healthcare Organization (MBHO) The Cheshire Dental Health Maintenance Organization (DHMO)
As part of its credentialing process, Omni would like to verify that each of these providers has met NCQA's accreditation standards. However, with regard to these three specialty service providers, an NCQA accreditation program currently exists for

Apex and Baxter only
Apex and Cheshire only
Baxter and Cheshire only
Baxter only

Answer(s): D

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QUESTION: 98

Many health plans opt to carve out behavioral healthcare (BH) services. However, one argument against carving out BH services is that this action most likely can result in

Slower access to BH care for plan members
Increased collaboration between BH providers and PCPs
Fewer specialized BH services for plan members
Decreased continuity of BH care for plan members

Answer(s): D

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QUESTION: 99

The following statements are about managed dental care. Three of these statements are true, and one is false. Select the answer choice containing the FALSE statement.

Managed dental care is federally regulated.
Dental HMOs typically need very few healthcare facilities because almost all dental services are delivered in an ambulatory care setting.
Currently, there are no nationally recognized standards for quality in managed dental care.
Processes for selecting dental care providers vary greatly according to state regulations on managed dental care networks and the health plan's standards.

Answer(s): A

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QUESTION: 100

Jay Mercer is covered under his health plan's vision care plan, which includes coverage for clinical eye care but not for routine eye care. Recently, Mr. Mercer had a general eye examination and got a prescription for corrective lenses. Mr. Mercer's vision care plan will cover.

both the general eye examination and the prescription for corrective lenses
the general eye examination only
the prescription for corrective lenses only
neither the general eye examination nor the prescription for corrective lenses

Answer(s): D

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Free AHM-530 Exam Braindumps (page: 26)

QUESTION: 97

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QUESTION: 99

QUESTION: 100

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