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AHIP Exam AHM-530 Topic 1 Question 65 Discussion

Actual exam question for AHIP's AHM-530 exam
Question #: 65
Topic #: 1
[All AHM-530 Questions]

When the Rialto Health Plan determines which of the emergency services received by its plan members should be covered by the health plan, it is guided by a standard which describes emergencies as medical conditions manifesting themselves by acute symptoms of sufficient severity (including severe pain) such that a person who possesses an average knowledge of health and medicine could reasonably expect the absence of immediate medical attention to result in placing the health of the individual in serious jeopardy. This standard, which was adopted by the NAIC in 1996, is referred to as the

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Suggested Answer: A

Contribute your Thoughts:

Danica
3 days ago
I'm not sure, but I think it's between A) medical necessity standard and B) prudent layperson standard.
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Bong
7 days ago
I agree with Han, the prudent layperson standard makes sense for determining emergency services coverage.
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Han
8 days ago
I think the answer is B) prudent layperson standard.
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