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AHIP AHM-530 Exam With Confidence Using Practice Dumps

Exam Code:
AHM-530
Exam Name:
Network Management
Certification:
AHIP Certification
Vendor:
AHIP
Questions:
202
Last Updated:
Feb 2, 2026
Exam Status:
Stable
AHIP AHM-530

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

Are you worried about passing the AHIP AHM-530 (Network Management) exam? Download the most recent AHIP AHM-530 braindumps with answers that are 100% real. After downloading the AHIP AHM-530 exam dumps training , you can receive 99 days of free updates, making this website one of the best options to save additional money. In order to help you prepare for the AHIP AHM-530 exam questions and verified answers by IT certified experts, CertsTopics has put together a complete collection of dumps questions and answers. To help you prepare and pass the AHIP AHM-530 exam on your first attempt, we have compiled actual exam questions and their answers. 

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Network Management Questions and Answers

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Question 1

The method that the Autumn Health Plan uses for reimbursing dermatologists in its provider network involves paying them out of a fixed pool of funds that is actuarially determined for this specialty. The amount of funds that Autumn allocates to dermatologists is based on utilization and costs of services for that discipline.

Under this reimbursement method, a dermatologist who is under contract to Autumn accumulates one point for each new referral made to the specialist by Autumn’s PCPs. If the referral is classified as complicated, then the dermatologist receives 1.5 points. The value of Autumn’s dermatology services fund for the first quarter was $15,000. During the quarter, Autumn’s PCPs made 90 referrals, and 20 of these referrals were classified as complicated.

Autumn’s method of reimbursing specialty providers can best be described as a

Options:

A.

Disease-specific arrangement

B.

Contact capitation arrangement

C.

Risk adjustment arrangement

D.

Withhold arrangement

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Question 2

Health plans are required to follow several regulations and guidelines regarding the access and adequacy of their provider networks. The Federal Employee Health Benefits Program (FEHBP) regulations, for example, require that health plans

Options:

A.

Allow members direct access to OB/GYN services

B.

Allow members direct access to prescription drug services

C.

Provide access to Title X family-planning clinics

D.

Provide average office waiting times of no more than 30 minutes for appointments with plan providers

Question 3

The Pine Health Plan has incorporated pharmacy benefits management into its operations to form a unified benefit. Potential advantages that Pine can receive from this action include:

Options:

A.

the fact that unified benefits improve the quality of patient care and the value of pharmacy services to Pine's plan members

B.

the fact that control over the formulary and network contracting can give Pine control over patient access to prescription drugs and to pharmacies

C.

the fact that managing pharmacy benefits in-house gives Pine a better chance to meet customer needs by integrating pharmacy services into the plan's total benefits package

D.

all of the above

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