Free AHIP AHM-520 Exam Questions
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AHIP AHM-520 Exam Questions
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Provided By: AHIP
- Exam: Health Plan Finance and Risk Management (AHM520)
- Certification: AHIP Certification
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Total Questions: 215
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Updated On: Feb 20, 2025
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Rated: 4.9 |
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Online Users: 430
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Question 1
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Federal law addresses the relationship between Medicare- or Medicaid contracting health plans and providers who are at "substantial financial risk."
Under federal law, Medicare- or Medicaid-contracting health plans:
Answer: C
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Federal law addresses the relationship between Medicare- or Medicaid contracting health plans and providers who are at "substantial financial risk."
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Question 2
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In a fee-for-service (FFS) reimbursement method, providers are paid per treatment or per service that they provide.
One typical benefit of FFS reimbursement is that it:
Answer: B
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In a fee-for-service (FFS) reimbursement method, providers are paid per treatment or per service that they provide.
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Question 3
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The following statements illustrate the use of different rating methods by health plans: The Dover health plan established rates for small groups by using a rating method which requires that the average premium in each group cannot be more than 120% of the average premium for any other group. Under this method, all members of each group pay the same premium, which is based on the experience of the group.
Under the rating method used by the Rolling Hills health plan, the health plan calculates the ratio of a group's experience to the group's historical manual rate. Rolling Hills then multiplies this ratio by the group's future manual rate. Rolling Hills cannot consider the group's experience in determining premium rates. From the following answer choices, select the response that correctly indicates the rating methods used by Dover and Rolling Hills.
Answer: D
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The following statements illustrate the use of different rating methods by health plans: The Dover health plan established rates for small groups by using a rating method which requires that the average premium in each group cannot be more than 120% of the average premium for any other group. Under this method, all members of each group pay the same premium, which is based on the experience of the group.
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Question 4
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The Fairway health plan is a for-profit health plan that issues stock. The following data was taken from Fairway's financial statements:
Current assets.....$5,000,000 -
Total assets.....$6,000,000 -
Current liabilities.....$2,500,000
Total liabilities.....$3,600,000
Stockholders' equity.....$2,400,000
Fairway's total revenues for the previous financial period were $7,200,000, and its net income for that period was $180,000.
Assume that the healthcare industry average for the debt-to-equity ratio is 0.90.
The following statement(s) can correctly be made about Fairway's debt to equity ratio:
Answer: B
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The Fairway health plan is a for-profit health plan that issues stock. The following data was taken from Fairway's financial statements:
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Question 5
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A health plan's costs can be classified as committed costs or discretionary costs. An example of a discretionary cost for a health plan is the cost of its:
Answer: A
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A health plan's costs can be classified as committed costs or discretionary costs. An example of a discretionary cost for a health plan is the cost of its: