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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:
Jul 17, 2025
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

Variance analysis is the study of the difference between expected results and actual results. Variances can be positive or negative. A positive variance is typically considered:

Options:

A.

favorable for both expenses and revenues

B.

favorable for expenses, but unfavorable for revenues

C.

favorable for revenues, but unfavorable for expenses

D.

unfavorable for both expenses and revenues

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Question 2

One true statement about cash-basis accounting is that

Options:

A.

Cash receipt, but not cash disbursement, is an important component of cash-basis accounting

B.

Most companies use a pure cash-basis accounting system

C.

Cash-basis accounting records revenue according to the realization principle and expenses according to the matching principle

D.

Health insurance companies and health plans that fall under the jurisdiction of state insurance commissioners must report some items on a cash basis for statutory reporting purposes

Question 3

The following statements illustrate common forms of capitation:

1. The Antler Health Plan pays the Epsilon Group, an integrated delivery system (IDS), a capitated amount to provide substantially all of the inpatient and outpatient services that Antler offers. Under this arrangement, Epsilon accepts much of the risk that utilization rates will be higher than expected. Antler retains responsibility for the plan's marketing, enrollment, premium billing, actuarial, underwriting, and member services functions.

2. The Bengal Health Plan pays an independent physician association (IPA) a capitated amount to provide both primary and specialty care to Bengal's plan members. The payments cover all physician services and associated diagnostic tests and laboratory work. The physicians in the IPA determine as a group how the individual physicians will be paid for their services.

From the following answer choices, select the response that best indicates the form of capitation used by Antler and Bengal.

Options:

A.

Antler = subcapitation

Bengal = full-risk capitation

B.

Antler = subcapitation

Bengal = full professional capitation

C.

Antler = global capitation

Bengal = subcapitation

D.

Antler = global capitation

Bengal = full professional capitation