AHIP Exam AHM-540 Topic 1 Question 104 Discussion

Actual exam question for AHIP's AHM-540 exam

Question #: 104
Topic #: 1

To see that utilization guidelines are consistently applied, UR programs rely on authorization systems. Determine whether the following statement about authorization systems is true or false:

Only physicians can make nonauthorization decisions based on medical necessity.

ATrue

BFalse

Show Suggested Answer

Suggested Answer: B

by Elmira at Dec 09, 2024, 11:35 AM

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Tish

23 hours ago

Hmm, I'm pretty sure the answer is B) False. Most UR programs allow case managers, nurses, and other clinicians to make nonauthorization decisions in addition to physicians. Physicians don't have the monopoly on that power.

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Nettie

3 days ago

Ugh, I hate these True/False questions. There's always some little caveat that makes it not a straightforward answer. I'm just going to guess B) False and hope for the best.

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Rosalind

10 days ago

This is a tricky one. While physicians typically have the final say on medical necessity, some UR programs may allow other qualified healthcare professionals to make nonauthorization decisions as well. I'll have to think carefully about this one.

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