最新なAHIP AHM-250問題集（367題）、真実試験の問題を全部にカバー！

質問 1：
The following statement(s) can correctly be made about electronic data interchange (EDI):
A. A only
B. B only
C. Both A and B
D. Neither A nor B
E. EDI differs from eCommerce in that EDI involves back-and-forth exchanges of information concerning individual transactions, whereas eCommerce is the transfer of d
正解：A

質問 2：
The Polestar Company's sole business is the ownership of Polaris Medical Group, a health plan and subsidiary of Polestar. Some members of Polestar's board of directors hold positions with Polestar in addition to their positions on the board; the rest are professionals in academia and businesspeople who do not work for Polestar. Dr. Carolyn Porter, a university president, is on Polestar's board. From the following answer choices, select the response containing the term that correctly identifies Polestar's relationship to Polaris and the term that describes the type of board member represented by Dr. Porter
A. Polestar's relationship to Polaris: holding company: Type of board member: operations director
B. Poles tar's relationship to Polaris: holding company: Type of board member: outside director
C. Polestar's relationship to Polaris: partnership: Type of board member: operations director
D. Polestar's relationship to Polaris: partnership: Type of board member: outside director
正解：B

質問 3：
Historically most HMOs have been
A. Closed-panel HMO
B. Closed-access HMO
C. Open-panel HMO
D. Open-access HMO
正解：A

質問 4：
In addition to the credentialing activities that an health plan performs when initially accepting a provider into its network, the health plan must also perform recredentialing of the same providers on an ongoing basis. Many of the same activities are per
A. performance of site inspections in a provider's facilities
B. review of information from a provider's quality improvement activities
C. verification of a provider's licensure and certification
D. verification of a network provider's medical education and residency
正解：D

質問 5：
A public employer, such as a municipality or county government would be considered which of the following?
A. Employer-employee group
B. Multiple-employer group
C. Debtor-creditor group
D. Affinity group
正解：A

質問 6：
Before the Hill Health Maintenance Organization (HMO) received a certificate of authority (COA) to operate in State X, it had to meet the state's licensing requirements and financial standards which were established by legislation that is identical to the
A. Hill had to be organized as a partnership in order to obtain a COA
B. The COA most likely exempts Hill from any of State X's enabling statutes.
C. The COA in no way indicates that Hill has demonstrated that it is fiscally sound.
D. Hill had to have an initial net worth of at least $1.5 million in order to obtain a CO
正解：D

質問 7：
Exclusive provider organizations (EPO) is similar and operates like a PPO in administration, structure but however in an EPO an out-of-network care is
A. Partially Covered
B. Covered with more out of pocket
C. Not covered
正解：C

質問 8：
Federal legislation has placed the primary responsibility for regulating health insurance companies and HMOs that service private sector (commercial) plan members at the state level.
This federal legislation is the
A. Sherman Act
B. Clayton Act
C. McCarran-Ferguson Act
D. Federal Trade Commission Act
正解：C