AAMCN EXAM LATEST 2025 QUESTIONS WITH
100% VERIFIED SOLUTIONS!!
Failure to obtain informed consent can lead to? Answer - Assault and battery
Healthcare Reform Act Answer - The major healthcare legislation passed in
2010 designed to make healthcare accessible and less expensive for more
Americans., pre-existing conditions
What is grievance policy? Answer - A formal review mechanism which allows a
person to have their complaint abt a policy or action reconsidered.
Living a principle centered life involves 2 things: Answer - Humility and courage
Three components of information security Answer - Confidentiality, integrity,
availability
ADR alternative dispute resolution Answer - Beyond appeal, alternative to
filing a lawsuit, between the plan and provider; NOT the participant.
What avenues of recourse are w/i pv contract? Answer - Grievance (appeals),
alternative dispute resolution
Mediation Answer - Reaching agreement/consensus abt issue
Arbitration Answer - Agreement that parties will take dispute to a panel
, Common bases for lawsuits against mco's Answer - Breach of contract,
negligence, antitrust, breach of fiduciary duty, RICO racketeering and corrupt
organizations act
Breach of contract Answer - Failure to comply with an agreement which results
in damages to at least one of the parties to the agreement or to an intended
beneficiary
Negligence elements Answer - Direct or vicarious liability, duty, breach of duty,
causation, damages, malpractice, UM, credentialing
Negligence Answer - Lack of adherence caused Pt harm
Largest/accredits programs that do biz in q state Answer - Urac
Deemed org for federal programs Answer - Urac
Joint comission Answer - Receipt of Medicaid reimbursement, publishes natl
standards
NCQA nat'l committee for quality assurance Answer - Private, not for profit
organization, improves quality of managed care plans. Est 1990
HEDIS Answer - A nationally accepted performance instrument administered
by NCQA to measure a mco performance
4 domains of qismc Answer - Quality assessment and performance
improvement, enrollee rights, health srvcs mgmnt, delegation
100% VERIFIED SOLUTIONS!!
Failure to obtain informed consent can lead to? Answer - Assault and battery
Healthcare Reform Act Answer - The major healthcare legislation passed in
2010 designed to make healthcare accessible and less expensive for more
Americans., pre-existing conditions
What is grievance policy? Answer - A formal review mechanism which allows a
person to have their complaint abt a policy or action reconsidered.
Living a principle centered life involves 2 things: Answer - Humility and courage
Three components of information security Answer - Confidentiality, integrity,
availability
ADR alternative dispute resolution Answer - Beyond appeal, alternative to
filing a lawsuit, between the plan and provider; NOT the participant.
What avenues of recourse are w/i pv contract? Answer - Grievance (appeals),
alternative dispute resolution
Mediation Answer - Reaching agreement/consensus abt issue
Arbitration Answer - Agreement that parties will take dispute to a panel
, Common bases for lawsuits against mco's Answer - Breach of contract,
negligence, antitrust, breach of fiduciary duty, RICO racketeering and corrupt
organizations act
Breach of contract Answer - Failure to comply with an agreement which results
in damages to at least one of the parties to the agreement or to an intended
beneficiary
Negligence elements Answer - Direct or vicarious liability, duty, breach of duty,
causation, damages, malpractice, UM, credentialing
Negligence Answer - Lack of adherence caused Pt harm
Largest/accredits programs that do biz in q state Answer - Urac
Deemed org for federal programs Answer - Urac
Joint comission Answer - Receipt of Medicaid reimbursement, publishes natl
standards
NCQA nat'l committee for quality assurance Answer - Private, not for profit
organization, improves quality of managed care plans. Est 1990
HEDIS Answer - A nationally accepted performance instrument administered
by NCQA to measure a mco performance
4 domains of qismc Answer - Quality assessment and performance
improvement, enrollee rights, health srvcs mgmnt, delegation
