Free AHIP AHM-530 Exam Questions
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AHIP AHM-530 Exam Questions
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Provided By: AHIP
- Exam: Network Management (AHM530)
- Certification: AHIP Certification
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Total Questions: 205
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Updated On: Jun 04, 2025
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Rated: 4.9 |
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Online Users: 410
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Question 1
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One reimbursement method that health plans can use for hospitals is the ambulatory payment
classifications (APCs) method. APCs bear a resemblance to the diagnosis-related groups (DRGs)
method of reimbursement. However, when comparing APCs and DRGs, one of the primary
differences between the two methods is that only the APC method
Answer: A
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One reimbursement method that health plans can use for hospitals is the ambulatory payment
classifications (APCs) method. APCs bear a resemblance to the diagnosis-related groups (DRGs)
method of reimbursement. However, when comparing APCs and DRGs, one of the primary
differences between the two methods is that only the APC method
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Question 2
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The Walnut Health Plan provides a number of specialty services for its members. Walnut offers
coverage of alternative healthcare, including coverage of treatment methods such as homeopathy and naturopathy. Walnut also offers home healthcare services, and it contracts with home
healthcare providers on a non-risk basis to the health plan. The following statements are about the
specialty services offered by Walnut. Select the answer choice containing the correct statement:
Answer: A
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The Walnut Health Plan provides a number of specialty services for its members. Walnut offers
coverage of alternative healthcare, including coverage of treatment methods such as homeopathy and naturopathy. Walnut also offers home healthcare services, and it contracts with home
healthcare providers on a non-risk basis to the health plan. The following statements are about the
specialty services offered by Walnut. Select the answer choice containing the correct statement:
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Question 3
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The Walnut Health Plan provides a number of specialty services for its members. Walnut offers
coverage of alternative healthcare, including coverage of treatment methods such as homeopathy and naturopathy. Walnut also offers home healthcare services, and it contracts with home
healthcare providers on a non-risk basis to the health plan. The following statements are about the
specialty services offered by Walnut. Select the answer choice containing the correct statement:
Answer: A
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The Walnut Health Plan provides a number of specialty services for its members. Walnut offers
coverage of alternative healthcare, including coverage of treatment methods such as homeopathy and naturopathy. Walnut also offers home healthcare services, and it contracts with home
healthcare providers on a non-risk basis to the health plan. The following statements are about the
specialty services offered by Walnut. Select the answer choice containing the correct statement:
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Question 4
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The Ionic Group, a provider group with 10,000 plan members, purchased for its hospital risk pool
aggregate stop-loss insurance with a threshold of 110% of projected costs and a 10% coinsurance
provision. Ionic funds the hospital risk pool at $40 per member per month (PMPM).
If Ionic’s actual hospital costs are $5,580,000 for the year, then, under the aggregate stop-loss
agreement, the stop-loss insurer is responsible for reimbursing Ionic in the amount of
Answer: B
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The Ionic Group, a provider group with 10,000 plan members, purchased for its hospital risk pool
aggregate stop-loss insurance with a threshold of 110% of projected costs and a 10% coinsurance
provision. Ionic funds the hospital risk pool at $40 per member per month (PMPM).
If Ionic’s actual hospital costs are $5,580,000 for the year, then, under the aggregate stop-loss
agreement, the stop-loss insurer is responsible for reimbursing Ionic in the amount of
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Question 5
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The following statements are about fee-for-service (FFS) payment systems. Select the answer
choice containing the correct statement:
Answer: B
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The following statements are about fee-for-service (FFS) payment systems. Select the answer
choice containing the correct statement: