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AHIP AHM-520 Dumps Questions Answers

AHM-520 exam

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Health Plan Finance and Risk Management

Last Update Nov 21, 2024
Total Questions : 215

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Last Update Nov 21, 2024
Total Questions : 215

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Health Plan Finance and Risk Management Questions and Answers

Questions 1

One law prohibits Dr. Laura Cole from making a referral to another provider entity for designated health services if Dr. Cole or one of her immediate family members has a financial relationship with the entity. This law is known as the

Options:

A.

safe harbor law

B.

upper payment limit law

C.

anti-kickback law

D.

physician self-referral law

Questions 2

With regard to the major risk factors associated with group underwriting, it can correctly be stated that, typically,

Options:

A.

The age and gender of group plan members are not predictors of utilization of health services by group members

B.

A health plan's product design or delivery system has an impact on member selection of the health plan, unless the members are in an environment in which employees have at least two benefit options or health plans from which to choose

C.

A health plan should track demographic factors of groups only if the plan specifically adjusts for demographic factors on a group basis

D.

A large group is more likely to exhibit a consistent claims pattern, level of healthcare cost, or utilization of services than is a small group

Questions 3

Two sets of financial accounting standards are generally accepted accounting principles (GAAP) and statutory accounting practices (SAP). One true statement about these financial accounting standards is that

Options:

A.

State laws and regulations in the United States govern the implementation of GAAP, but not the implementation of SAP

B.

Health plans must prepare their financial statements for their external users according to applicable laws, regulations, and accounting principles, particularly GAAP

C.

GAAP specifically focuses on the requirements of insurance regulators and policyholder interests

D.

The Financial Accounting Standards Board (FASB) is a private organization whose purpose is to establish and promote SAP in the United States

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