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

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Skye

19 days ago

I'm not sure, but I think it could also be B) Medical policy.

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Walton

20 days ago

I agree with Jenelle, CPGs are used for making coverage decisions.

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Jenelle

24 days ago

I think the answer is A) A clinical practice guideline (CPG).

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