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AHIP AHM-530 Exam With Confidence Using Practice Dumps

Exam Code:
AHM-530
Exam Name:
Network Management
Certification:
Vendor:
Questions:
202
Last Updated:
Jan 25, 2026
Exam Status:
Stable
AHIP AHM-530

AHM-530: AHIP Certification Exam 2025 Study Guide Pdf and Test Engine

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Network Management Questions and Answers

Question 1

The following statements are about fee-for-service (FFS) payment systems. Select the answer choice containing the correct statement:

Options:

A.

A discounted fee-for-service (DFFS) system is usually easier for a health plan to administer than is a fee schedule system.

B.

A case rate payment system offers providers an incentive to take an active role in managing cost and utilization.

C.

One reason that health plans use a relative value scale (RVS) payment system is that RVS values for cognitive services have traditionally been higher than the values for procedural services.

D.

One reason that health plans use a resource-based relative value scale (RBRVS) is that this system includes weighted unit values for all types of procedures.

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Question 2

Dr. Michelle Kubiak has contracted with the Gem Health Plan, a Medicare+Choice health plan, to provide medical services to Gem's enrollees. Gem pays Dr. Kubiak $40 per enrollee per month for providing primary care. Gem also pays her an additional $10 per enrollee per month if the cost of referral services falls below a targeted level. This information indicates that, according to the substantial financial risk formula, Dr. Kubiak's referral risk under this contract is equal to:

Options:

A.

20%, and therefore this arrangement puts her at substantial financial risk

B.

20%, and therefore this arrangement does not put her at substantial financial risk

C.

25%, and therefore this arrangement puts her at substantial financial risk

D.

25%, and therefore this arrangement does not put her at substantial financial risk

Question 3

Before or during the orientation process, health plans generally provide new network providers with a provider manual. One of the primary purposes of the provider manual is to

Options:

A.

Provide a directory of contracted providers

B.

Help providers and their staffs develop methods of improving the operation of their practices

C.

Provide feedback to providers regarding their performance

D.

Reinforce and document contractual provisions