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AHM-520 Dumps - Health Plan Finance and Risk Management Practice Exam Questions

AHIP AHM-520 - Health Plan Finance and Risk Management Braindumps

AHIP AHM-520 - AHIP Certification Practice Exam

  • Certification Provider:AHIP
  • Exam Code:AHM-520
  • Exam Name:Health Plan Finance and Risk Management Exam
  • Total Questions:215 Questions and Answers
  • Updated on:Nov 29, 2024
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AHIP AHM-520 This Week Result

AHM-520 Question and Answers

Question # 1

The NAIC has developed a risk-based capital (RBC) formula for all health plans that accept risk. One true statement about the RBC formula for health plans is that it

Options:

A.  

is a set of calculations, based on information in a health plan's annual financial report, that yields a target capital requirement for the organization

B.  

fails to take into account a health plan's underwriting risk, which is the risk that the premiums the health plan receives will be insufficient to pay for the healthcare services it provides to its plan members

C.  

applies to all health plans in the United States

D.  

fails to assess the specific level of risk faced by each health plan

Discussion 0
Question # 2

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

Options:

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

Discussion 0
Question # 3

Because a health plan cannot decline coverage for individuals who are eligible for conversion of group health coverage to individual health coverage, the bulk of the health plan's underwriting for conversion policies is accomplished through health plan design.

Options:

A.  

True

B.  

False

Discussion 0

PDF vs Software Version

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