AHIP Bundled Exams 2024/2025 with complete solutions

ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its enrollees' protected health information to market non-health related products such as life insurance and annuities. To do so it must obtain authorization from the enrollees. Which statement best describes the authorization p...

(W) Mr. Alonso receives some help paying for his two generic prescription drugs from his employer's retiree coverage, but he wants to compare it to a Part D prescription drug plan. He asks you what costs he would generally expect to encounter when enrolling into a standard Medicare Part D prescri...

At a minimum, an effective compliance program includes four core requirements - False Compliance is the responsibility of the compliance officer, compliance committee and upper management only - False Correcting non-compliance - Protects enrollees, avoids recurrence of the same non-compliance, a...

Charles McCarthy is a Medicare beneficiary who suffers from diabetes. Mr. McCarthy is considering enrollment in a MA-PD plan that you represent. He asks you whether his insulin costs will be covered. What should you say? - Mr. McCarthy's insulin costs for a one-month supply cannot be more than $...

Mr. Alonso receives some help paying for his two generic prescription drugs from his employer's retiree coverage, but he wants to compare it to a Part D prescription drug plan. He asks you what costs he would generally expect to encounter when enrolling into a standard Medicare Part D prescriptio...

All plans must cover at least the standard Part D coverage or its actuarial equivalent. Which of the following statements best describes some of the costs a beneficiary would incur for prescription drugs under the standard coverage? - Mr. and Mrs. Vaughn both take a specialized multivitamin presc...

A Medicare beneficiary has walked into your office and requested that you sit down with her and discuss her options under the Medicare Advantage program. Before engaging in such a discussion, what should you do? - Answer-You must have her sign a scope of appointment form, indicating which products...

A client wants to give you an enrollment application on October 1 before the beginning of the Annual Election Period because he is leaving on vacation for two weeks and does not want to forget about turning it in. What should you tell him? - You must tell him you are not permitted to take the for...

Daniel is a middle-income Medicare beneficiary. He has chronic bronchitis, putting him at severe risk for pneumonia. Otherwise, he has no problems functioning. Which type of SNP is likely to be most appropriate for him? - C-SNP Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but ac...

A person comes into your pharmacy to drop off a prescription for a beneficiary who is a regular customer. The prescription is for a controlled substance with a quantity of 160. This beneficiary normally receives a quantity of 60, not 160. You review the prescription and have concerns about the pos...

Daniel is a middle-income Medicare beneficiary. He has chronic bronchitis, putting him at severe risk for pneumonia. Otherwise, he has no problems functioning. Which type of SNP is likely to be most appropriate for him? - C-SNP Mr. Davies is turning 65 next month. He would like to enroll in a Med...

An Example of Health Plan Employee abuse - Maria Adams works for a Medicare plan. She uses the plan's email to send out information to enrollees of the plan promoting her husband's sports memorabilia business. (This activity would also be in violation of HIPPA privacy rules) AUDIT - **A methodi...