AHM-530 Healthcare Practice Questions
The free AHM-530: Network Management questions that deal with healthcare, with answers and explanations. The full bank and the timed practice test cover every topic the exam asks about.
Question #4
Many health plans opt to carve out behavioral healthcare (BH) services. However, one argument against carving out BH services is that this action most likely can result in
Correct answer: D
Explanation
Carving out behavioral health separates BH providers from PCPs and the medical network, which can fragment care and reduce continuity; carve-outs generally speed access and add specialized services.
Question #5
If a third party is responsible for injuries to a plan member of the Hope Health Plan, then Hope has a contractual right to file a claim for the resulting healthcare costs against the third party. This contractual right to recovery from the third party is known as
Correct answer: A
Explanation
Subrogation is the plan's right to recover benefits it paid from a third party liable for the member's injury; coordination of benefits applies between two coverages, not liable third parties.
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