AHM-540Medical Management
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Last Updated Apr 25, 2024 Ace your exams with our consistently updated AHM-540 exam dumps.
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AHM-540 Online Practice Questions and Answers
The American Accreditation HealthCare Commission/URAC (URAC) has an accreditation program specifically for case management services. From the answer choices below, select the response that correctly identifies the type(s) of case management services addressed by URAC's standards and the type
(s)
of organizations to which these standards may be applied.
A.
Type(s) of Services-on-site services only Type(s) of Organization-health plans only
B.
Type(s) of Services-on-site services only Type(s) of Organization-any organization that performs case management functions
C.
Type(s) of Services-both telephonic and on-site services Type(s) of Organization-health plans only
D.
Type(s) of Services-both telephonic and on-site services Type(s) of Organization-any organization that performs case management functions
Nilay Sharma suffered a small wound while working in his yard and was taken to a local hospital for treatment. A triage nurse at the hospital evaluated Mr. Sharma's condition and directed him to an outpatient unit in the hospital where a physician assistant examined, cleaned, and sutured the wound. Mr. Sharma returned home following treatment. The care Mr. Sharma received at the hospital is an example of the type of care known as
A. specialty referral
B. primary prevention
C. urgent care
D. emergency care
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.
A. True
B. False
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