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AHIP AHM-520 Exam With Confidence Using Practice Dumps

Exam Code:
AHM-520
Exam Name:
Health Plan Finance and Risk Management
Certification:
Vendor:
Questions:
215
Last Updated:
Jan 21, 2026
Exam Status:
Stable
AHIP AHM-520

AHM-520: AHIP Certification Exam 2025 Study Guide Pdf and Test Engine

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Related AHIP Exams

Health Plan Finance and Risk Management Questions and Answers

Question 1

The Coral Health Plan, a for-profit health plan, has two sources of capital:

Debt and equity. With regard to these sources of capital, it can correctly be stated that

Options:

A.

Coral's equity holders have an ownership interest in the health plan

B.

The interest that Coral pays on its debt most likely is not tax deductible to Coral

C.

Coral's debt holders have no legal claim to Coral's assets

D.

Equity is a more risky source of capital, from Coral's perspective, than is debt

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Question 2

Geena Falk is eligible for both Medicare and Medicaid coverage. If Ms. Falk incurs a covered expense, then:

Options:

A.

Medicaid will be Ms. Falk’s primary insurer

B.

Medicare will be Ms. Falk’s primary insurer

C.

Either Medicare or Medicaid will be Ms. Falk’s primary insurer depending on her election

D.

Medicare and Medicaid will each be responsible for one-half of Ms. Falk’s covered expense

Question 3

The Marble Health Plan sets aside a PMPM amount for each specialty.

When a PCP in Marble's provider network refers a Marble plan member to a specialist and the specialist provides medical services to the member, the specialist begins to receive a share of those funds on a monthly basis. Marble determines the monthly payment for each specialist by dividing the number of active patients for that specialty by the total specialty pool for that month.

This form of payment, which is similar to a case rate, is known as

Options:

A.

Referral circle capitation

B.

Risk pod capitation

C.

Contact capitation

D.

Retrospective reimbursement capitation