AHIP Exam AHM-540 Topic 5 Question 103 Discussion

Actual exam question for AHIP's AHM-540 exam

Question #: 103
Topic #: 5

Health plans have a specified number of working days to respond to Level One appeals, as stated by company policy or regulatory requirements. With regard to the timeframes for appeals, it is generally correct to say

That the typical timeframe requires a health plan to respond to appeals in fewer than 20 days

That the timeframe is accelerated for expedited appeals

That the review period begins when the appeal arrives at a health plan

AAll of the above

B1 and 2 only

C1 and 3 only

D2 and 3 only

Show Suggested Answer

Suggested Answer: D

by Sheron at Nov 18, 2024, 10:54 AM

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Moon

7 days ago

Wait, does that mean I have to respond to my own appeals within 20 days? I better start working on that backlog! Just kidding, I know these rules are for the health plans, not us patients.

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Stevie

12 days ago

Haha, I bet the exam writers had fun coming up with these options. 'Fewer than 20 days' - that's a pretty specific timeframe, don't you think? I'll keep that in mind when I see similar questions.

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Callie

20 days ago

I agree with Hershel. The timeframes for appeals can be tricky, but this question covers the key points. I'm glad I reviewed those regulations before the exam.

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Hershel

23 days ago

The correct answer is B) 1 and 2 only. Health plans typically have a shorter timeframe for expedited appeals, and the review period starts when the appeal arrives at the health plan.

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