AHIP Exam AHM-540 Topic 1 Question 90 Discussion

Actual exam question for AHIP's AHM-540 exam

Question #: 90
Topic #: 1

The paragraph below contains two pairs of terms or phrases enclosed in parentheses. Select the term or phrase in each pair that correctly completes the paragraph. Then select the answer choice containing the two terms or phrases you have chosen.

TRICARE enrollees have the right to challenge authorization and coverage decisions. Such challenges are referred to as (appeals / grievances) and are typically handled by the (TRICARE contractor / Area Field Office).

Aappeals / TRICARE contractor

Bappeals / Area Field Office

Cgrievances / TRICARE contractor

Dgrievances / Area Field Office

Show Suggested Answer

Suggested Answer: A

by Jesus at Jun 19, 2024, 02:25 AM

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Lindsey

5 months ago

I think Iluminada might be right, because grievances are also about challenging decisions and Area Field Office could handle them.

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Iluminada

5 months ago

I'm not sure, I think it could also be grievances and Area Field Office.

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Katheryn

5 months ago

I agree with Carissa, because appeals are about challenging decisions and TRICARE contractor handles them.

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Candida

5 months ago

Wait, are we supposed to know the difference between 'appeals' and 'grievances'? I thought they were the same thing! This is why I hate multiple-choice exams - they're designed to trick you.

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Heidy

4 months ago

Yeah, multiple-choice exams can be tricky, but now we know the difference!

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Burma

4 months ago

So, the correct answer would be appeals / TRICARE contractor.

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Mari

4 months ago

I agree, 'grievances' are handled by the Area Field Office.

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Kris

4 months ago

I think 'appeals' and 'grievances' are different. Appeals are handled by the TRICARE contractor.

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Orville

5 months ago

I can't believe they're testing us on TRICARE bureaucracy! This is like a whole other language. *sigh* I guess I'll just guess and hope for the best.

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Valentine

4 months ago

I think it's appeals and TRICARE contractor.

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Sharita

5 months ago

I know, this TRICARE stuff is so confusing.

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Carissa

5 months ago

I think the correct terms are appeals and TRICARE contractor.

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Lezlie

5 months ago

Hmm, I'm going to go with D) grievances / Area Field Office. It just seems more logical to me that the Area Field Office would handle these types of challenges.

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Corrie

5 months ago

I agree, it does seem like the Area Field Office would handle those types of challenges.

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Kenneth

5 months ago

I think you're right, D) grievances / Area Field Office does make more sense.

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Theodora

6 months ago

Well, I was leaning towards B) appeals / Area Field Office, but now I'm not so sure. This question is a bit tricky, isn't it?

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Phung

6 months ago

I think the correct answer is C) grievances / TRICARE contractor. TRICARE enrollees file grievances, not appeals, and the TRICARE contractor handles these, not the Area Field Office.

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Bea

5 months ago

Yes, and the TRICARE contractor handles these, not the Area Field Office.

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Socorro

5 months ago

I agree, TRICARE enrollees file grievances, not appeals.

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Aileen

5 months ago

I think the correct answer is C) grievances / TRICARE contractor.

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