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Exam Code: AHM-520 Exam Name: Health Plan Finance and Risk Management Exam Download Free Questions Answer of AHM-520 Exam.
About AHM About AHM- -520 Exam 520 Exam. . Get a comprehensive look at the Health Insurance Plan Fund. You will learn about financial management techniques, funds, risk management, provider payment, project risk, pricing, care, and rating methods. AHM-520 Exam Dumps AHM-520 Dumps AHM-520 Braindumps AHM-520 PDF Dumps
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Question No : 1 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 AHM-520 Exam Dumps AHM-520 Dumps AHM-520 Braindumps AHM-520 PDF Dumps
Question No : 2 A stop-loss contract may provide that claims are settled using a paid claims method or an incurred claims method. The Concord Company provides health coverage to its employees through a self-funded health plan. On March 17, a Concord employee who is enrolled in this plan underwent surgery, and the surgery was sufficiently expensive to trigger Concord's specific stop-loss coverage. On April 10, Concord paid the medical expenses associated with the surgery. The term of the stop-loss contract ended on April 1. This information indicates that the stop-loss carrier is responsible for paying a portion of the cost of the surgery under A. both the paid claims method and the incurred claims method B. the paid claims method but not the incurred claims method C. the incurred claims method but not the paid claims method D. neither the paid claims method nor the incurred claims method Answer: C AHM-520 Exam Dumps AHM-520 Dumps AHM-520 Braindumps AHM-520 PDF Dumps
Question No : 3 The following statement(s) can correctly be made about a health plan's underwriting of small groups: A. Typically, a health plan medically underwrites both the employees of a small group and their dependents, even though small group reform laws prohibit health plans from singling. out individuals for rejection or substandard rate-ups. B. In the absence of laws mandating otherwise, a health plan's underwriting standards grow stricter as group size gets smaller. C. Both A and B D. A only E. B only F. Neither A nor B Answer: A AHM-520 Exam Dumps AHM-520 Dumps AHM-520 Braindumps AHM-520 PDF Dumps
Question No : 4 The Challenger Group is a type of management services organization (MSO) that purchases the assets of physician practices, provides practice management andadministrative support servicesto participating providers, and offers physicians a longterm contract and an equity position in Challenger. This information indicates that Challenger is a type of health plan A. Known as B. An integrated delivery system (IDS) C. Amedical foundation D. Aprovider-sponsored organization (PSO) E. Aphysician practice management (PPM) company Answer: D AHM-520 Exam Dumps AHM-520 Dumps AHM-520 Braindumps AHM-520 PDF Dumps
Question No : 5 This concept, which is an extension of the going-concern concept, holds that the value of an asset that a company reports in its accounting records should be the asset's historical cost, not its current market value. Although this concept offers objectivity and reliability, it may lack relevance, particularly for assets held for a long period of time. From the following answer choices, choose the name of the accounting concept that matches the description. A. Measuring-unit concept B. Full-disclosure concept C. Cost concept D. Time-period concept Answer: C AHM-520 Exam Dumps AHM-520 Dumps AHM-520 Braindumps AHM-520 PDF Dumps
Question No : 6 The Caribou health plan is a for-profit organization. The financial statements that Caribou prepares include balance sheets, income statements, and cash flow statements. To prepare its cash flow statement, Caribou begins with the net income figure as reported on its income statement and then reconciles this amount to operating cash flows through a series of adjustments. Changes in Caribou's cash flow occur as a result of the health plan's operating activities, investing activities, and financing activities. Caribou is engaged in an operating activity when it A. Purchases or sells assets of the health plan B. Disposes of a subsidiary C. Repays funds loaned by its creditors D. Pays expenses associated with the healthcare services provided to its members Answer: D AHM-520 Exam Dumps AHM-520 Dumps AHM-520 Braindumps AHM-520 PDF Dumps
Question No : 7 The Proform Health Plan uses agents to market its small group business. Proform capitalizes the commission expense relating to this line of business by spreading the commissions over thepremium-paying period of the healthcare coverage. This approach to expense recognition is known as: A. Systematic and rational allocation B. Matching principle C. Immediate recognition D. Associating cause and effect Answer: D AHM-520 Exam Dumps AHM-520 Dumps AHM-520 Braindumps AHM-520 PDF Dumps
Question No : 8 The Jamal Health Plan operates in a state that mandates that a health plan either allow providers to become part of its network or reimburse those providers at the health plan’s negotiated-contract rate, so long as the non-contract provider is willing to perform the services at the contract rate. This type of law is known as: A. A fair procedure law B. A direct access law C. An any willing provider law D. A due process law Answer: C AHM-520 Exam Dumps AHM-520 Dumps AHM-520 Braindumps AHM-520 PDF Dumps
Question No : 9 One way that the Medicare and Medicaid programs differ is that under Medicare, a smaller proportion of provider reimbursement goes to the primary care providers and a greater proportion of the reimbursement goes to hospitals and specialists. A. True B. False Answer: A AHM-520 Exam Dumps AHM-520 Dumps AHM-520 Braindumps AHM-520 PDF Dumps
Question No : 10 A health plan can use cost accounting in order to A. Determine premium rates for its products B. Match the costs incurred during a given accounting period to the income earned in, or attributed to, that same period C. Both A and B D. A only E. B only F. Neither A nor B Answer: A AHM-520 Exam Dumps AHM-520 Dumps AHM-520 Braindumps AHM-520 PDF Dumps
AHM-520 Exam Dumps AHM-520 Dumps AHM-520 Braindumps AHM-520 PDF Dumps
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