Free Practice AHIP AHM-520 Exam Questions 2025

Stay ahead with 100% Free Health Plan Finance and Risk Management (AHM520) AHM-520 Dumps Practice Questions

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Total 215 Questions | Updated On: Apr 21, 2025

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Question 1

Users of the Fulcrum Health Plan financial information include:

The independent auditors who review Fulcrum's financial statements

Fulcrum's controller (comptroller)

Fulcrum's plan members -

The providers that deliver healthcare services to Fulcrum plan members

Fulcrum's competitors -

Of these users, the ones that most likely can correctly be classified as external users with a direct financial interest in Fulcrum are the:

A : Independent auditors, the plan members, the providers, and the competitors

B : Competitors only

C : Independent auditors, the controller, and the providers only

D : Controller and the competitors only

E : Plan members and the providers only

Answer: D

Question 2

The Atoll Health Plan must comply with a number of laws that directly affect the plan's contracts. One of these laws allows Atoll's plan members to receive medical services from certain specialists without first being referred to those specialists by a primary care provider (PCP). This law, which reduces the PCP's ability to manage utilization of these specialists, is known as _________.

A : A due process law

B : An any willing provider law

C : A direct access law

D : A fair procedure law

Answer: C

Question 3

Companies typically produce three types of budgets: operational budgets, cash budgets, and capital budgets. The following statements are about operational budgets. Select the answer choice containing the correct statement.

A : Expense budgets, a type of operational budget, typically describe fixed expenses rather than variable expenses.

B : Operational budgets can only show information by department or by line of business.

C : Operational budgets begin with a forecast of sales revenue and investment income.

D : Revenue budgets, a type of operational budget, indicate the amount of income from operations that a company received from the previous budget period

Answer: C

Question 4

Federal law addresses the relationship between Medicare- or Medicaid contracting health plans and providers who are at "substantial financial risk."

Under federal law, Medicare- or Medicaid-contracting health plans:

A : Place a provider at "substantial risk" whenever incentive arrangements put the provider at risk for amounts in excess of 10% of his or her total potential reimbursement for providing services to Medicare and Medicaid enrollees

B : Must provide stop-loss coverage to a provider who is placed at "substantial financial risk" for services that the provider does not directly provide to Medicare or Medicaid enrollees

C : Both A and B

D : A only

E : B only

F : Neither A nor B

Answer: C

Question 5

With regard to the financial statements prepared by health plans, it can correctly be stated that:

A : both for-profit, publicly owned health plans and not-for-profit health plans are required by law to provide all interested parties with an annual report

B : a health plan's annual report typically includes an independent auditor's report and notes to the financial statements

C : any health plan that owns more than 20% of the stock of a subsidiary company must compile the financial statements for the health plan's annual report on a consolidated basis

D : a health plan typically must prepare the financial statements included in its annual report according to SAP

Answer: B

Page: 1 / 43

Total 215 Questions | Updated On: Apr 21, 2025

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