AHIP Exam AHM-540 Topic 5 Question 84 Discussion

Actual exam question for AHIP's AHM-540 exam

Question #: 84
Topic #: 5

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 Roselle at Apr 14, 2024, 10:04 PM

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Jovita

9 months ago

I guess I'll go with A then, since both of you seem to agree on that choice.

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Craig

9 months ago

I see your point, but I still think A is the correct answer based on my understanding of the terms.

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Luis

10 months ago

But why would appeals be handled by the Area Field Office instead of the TRICARE contractor?

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Jovita

10 months ago

I don't think it's A, I believe it's B) appeals / Area Field Office.

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Craig

10 months ago

I agree with because appeals are usually handled by the TRICARE contractor.

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Luis

10 months ago

I think the answer is A) appeals / TRICARE contractor.

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Emily

10 months ago

I see your point Moira, but I still believe it's A) appeals / TRICARE contractor.

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Moira

10 months ago

I'm not sure, I think it could also be B) appeals / Area Field Office.

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Rickie

11 months ago

I agree with Emily, because appeals are usually handled by the TRICARE contractor.

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Emily

11 months ago

I think the answer is A) appeals / TRICARE contractor.

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Charlesetta

11 months ago

Yes, because appeals are usually handled by the TRICARE contractor.

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Nichelle

11 months ago

I agree with you, it's A) appeals / TRICARE contractor.

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Maile

11 months ago

Hmm, I'm not sure. I think I'll go with 'appeals' and 'Area Field Office' - that sounds right to me, but I could be wrong. *laughs* Guess we'll see on test day!

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Willow

12 months ago

Ugh, I hate these tricky wording questions. Can't they just ask us something straightforward for once? *sighs* Anyway, I'm going with 'grievances' and 'TRICARE contractor'.

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Alecia

12 months ago

Ah, I see what they're getting at. 'Grievances' is the term used, and the Area Field Office is where these are typically handled. Makes sense to me.

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Zachary

12 months ago

You know, I was just reading about this the other day. 'Appeals' is definitely the right term, and the TRICARE contractor is responsible for handling them. I'm pretty confident about that.

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Penney

12 months ago

Wait, I thought 'grievances' was the correct term for challenging decisions, not 'appeals'. And shouldn't the TRICARE Area Field Office be handling these cases, not the contractor? I'm a bit confused.

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Gayla

12 months ago

Hmm, this seems like a straightforward question about TRICARE procedures. I'd choose 'appeals' and 'TRICARE contractor' since that makes the most sense to me.

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