AHIP Exam AHM-540 Topic 2 Question 88 Discussion

Actual exam question for AHIP's AHM-540 exam

Question #: 88
Topic #: 2

The paragraph below contains an incomplete statement. Select the answer choice containing the term that correctly completes the paragraph.

To manage the delivery of healthcare services to their members, health plans use clinical practice parameters. ___________________ is the type of clinical practice parameter that a health plan uses to make coverage decisions concerning medical necessity and appropriateness.

AA clinical practice guideline (CPG)

BMedical policy

CBenefits administration policy

DA standard of care

Show Suggested Answer

Suggested Answer: D

by Emerson at May 17, 2024, 11:30 PM

Limited Time Offer

25%

Off

Get Premium AHM-540 Questions as Interactive Web-Based Practice Test or PDF

Contribute your Thoughts:

Submit Cancel

Corinne

1 months ago

The correct answer is obviously E. A magic 8-ball. That's how all the best health plans make their coverage decisions these days, right?

upvoted 0 times

...

Yolande

1 months ago

I'm leaning towards C. Benefits administration policy. It seems like the kind of policy that would guide coverage decisions, though I'm not 100% sure.

upvoted 0 times

Huey

10 days ago

I'm not sure, but B. Medical policy also sounds like it could be the right answer

upvoted 0 times

...

Detra

14 days ago

I agree, A sounds like it could be the correct choice

upvoted 0 times

...

Brittni

15 days ago

I think it might be A. Clinical practice guideline (CPG)

upvoted 0 times

...

Candra

1 months ago

Haha, this question is a real head-scratcher. I'm just going to go with D. A standard of care and hope for the best. That's the kind of 'clinical practice parameter' I use when I'm unsure.

upvoted 0 times

Adelaide

5 days ago

I would go with A) A clinical practice guideline (CPG).

upvoted 0 times

...

Ettie

18 days ago

I think it's B) Medical policy.

upvoted 0 times

...

Latanya

1 months ago

I'm going with A. A clinical practice guideline (CPG). It sounds like the kind of standardized approach health plans use to determine medical necessity.

upvoted 0 times

...

Alecia

2 months ago

I think the answer is B. Medical policy. That seems to be the term that best fits the description of a clinical practice parameter used for coverage decisions.

upvoted 0 times