Free Practice AHIP AHM-540 Exam Questions 2025

The paragraph below contains two pairs of terms in parentheses. Determine which term in eachpair correctly completes the paragraph. Then select the answer choice containing the two termsthat you have chosen.Health plans use both internal and external standards to assess the quality of the services thatthey provide. (Internal / External) standards are based on information such as published industrywideaverages or best practices of recognized industry leaders. Health plans primarily rely on(internal / external) standards to evaluate healthcare services. 

Demetrius Farrell, age 82, is suffering from a terminal illness and has consulted his health planabout the care options available to him. In order to avoid unwanted, futile interventions, Mr. Farrellsigned an advance directive that indicates the types of end-of-life medical treatment he wants toreceive. His family is to use this document as a guide should Mr. Farrell become incapacitated.For this question, if answer choices (A) through (C) are all correct, select answer choice (D).Otherwise, select the one correct answer choice.Decisions regarding Mr. Farrell’s end-of-life care are legally the right and responsibility of 

Comorbidity can have a significant impact on the effective implementation of disease management programs. Comorbidity can correctly be defined as the

Helena Ray, a member of the Harbrace Health Plan, suffers from migraine headaches. To treatMs. Ray’s condition, her physician has prescribed Upzil, a medication that has Food and DrugAdministration (FDA) approval only for the treatment of depression. Upzil has not been tested forsafety or effectiveness in the treatment of migraine headache. Although Harbrace’s medical policyfor migraine headache does not include coverage of Upzil, Harbrace has agreed to provide extracontractualcoverage of Upzil for Ms. Ray.In this situation, the prescribing of Upzil for Ms. Ray’s headaches is an example of 

Health plans that choose to contract with external organizations for pharmacy services typicallycontract with pharmacy benefit managers (PBMs). Functions that a PBM typically performs for ahealth plan include1. Managing the costs of prescription drugs2. Promoting efficient and safe drug use3. Determining the health plan’s internal management responsibilities for pharmacy services