AHM-510 Real Exam Prep DEMO

Question 1: Arthur Dace, a plan member of the Bloom Health Plan, tried repeatedly over an extended
period to schedule an appointment with Dr. Pyle, his primary care physician (PCP). Mr. Dace
informally surveyed other Bloom plan members and found that many people were experiencing
similar problems getting an appointment with this particular provider. Mr. Dace threatened to take
legal action against Bloom, alleging that the health plan had deliberately allowed a large number of
patients to select Dr. Pyle as their PCP, thus making it difficult for patients to make appointments
with Dr. Pyle.
Bloom recommended, and Mr. Dace agreed to use, an alternative dispute resolution (ADR) method
that is quicker and less expensive than litigation. Under this ADR method, both Bloom and Mr. Dace
presented their evidence to a panel of medical and legal experts, who issued a decision that Bloom's
utilization management practices in this case did not constitute a form of abuse. The panel's decision
is legally binding on both parties.
This information indicates that Bloom resolved its dispute with Mr. Dace by using an ADR method
known as:
A. Corporate risk management
B. An ombudsman program
C. An ethics committee
D. Arbitration
Correct Answer: D