AHIP Exam AHM-250 Topic 6 Question 82 Discussion

Actual exam question for AHIP's AHM-250 exam

Question #: 82
Topic #: 6

The following statements are about the various Health Plan Accountability Models adopted by the NAIC.

AUnder the terms of the Health Plan Network Adequacy Model Act, all health plans would be required to hold covered persons harmless against provider collections and provide continued coverage for uncompleted treatment in the event of plan insolvency

BThe Health Carrier Grievance Procedure Model Act requires all health carriers to maintain a first-level grievance review, but it does not require any second-level review

CAccording to the Health Care Professional Credentialing Verification Model Act, a health plan must select all providers who meet the plan's credentialing criteria

DThe Quality Assessment and Improvement Model Act exempts closed plans from implementing a quality improvement program.

Show Suggested Answer

Suggested Answer: A

by Amber at Mar 09, 2024, 03:20 AM

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Eladia

5 months ago

I'm not sure about Statement D, but it does make sense to exempt closed plans from quality improvement programs.

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Dulce

6 months ago

I believe Statement C is true because health plans should only select providers who meet the credentialing criteria to ensure quality care.

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Erick

6 months ago

I think Statement B might be false because most grievance procedures have multiple levels of review.

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Eladia

6 months ago

I think Statement A is true because it's important to protect covered persons in case of plan insolvency.

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Dulce

6 months ago

I agree, it's not easy to remember all the details of each model.

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Erick

6 months ago

I found the questions about Health Plan Accountability Models quite challenging.

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Lashawnda

6 months ago

Yes, that act focuses more on addressing grievances at an initial stage.

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Laquita

6 months ago

I remember reading about the Health Carrier Grievance Procedure Model Act, it requires first-level grievance review but not a second-level review.

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Jerry

6 months ago

That sounds fair, it protects the covered persons from financial burden.

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Lashon

7 months ago

I think under the Health Plan Network Adequacy Model Act, health plans have to provide continued coverage for uncompleted treatment in case of insolvency.

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Elfrieda

7 months ago

I'm not sure about the Health Plan Accountability Models adopted by the NAIC.

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