AHIP AHM-250 practice materials Questions Answers

Exam Code:
AHM-250
Exam Name:
Healthcare Management: An Introduction Exam
Last Update:
Jun 01,2026

367 Questions Answers Verified by Experts!


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AHIP AHM-250 Questions for Healthcare Management Certification Exam 2026

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Page: 1 / 74
Total Questions: 367

Questions & Answers PDF

• Question 1

  

  Which of the following statements is true?

  • A declining economy can lead to lower healthcare costs as a result of an older population with greater healthcare needs.
  • A larger patient population increases pressure on the health plan to offer larger panels.
  • Provider networks are not affected by the federal and state laws that apply to health plans
  • Network management standards established by independent accrediting organizations have no influence on health plan network design.

  Reveal Answer Answer: B Next Question

• Question 2

  

  The main advantage of using outcomes measures to evaluate healthcare quality is that they Typically

  • are easy to identify and report
  • demonstrate improved clinical and functional status over time
  • are insensitive to changes in structures or processes
  • provide meaningful feedback on care delivery even when the delay between treatment and outcome stretches over several years

  Reveal Answer Answer: B Next Question

• Question 3

  

  Members who qualify to participate in a health plan's case management program are typically assigned a case manager. During the course of the member's treatment, the case manager is responsible for

  • Coordinating and monitoring the member's care
  • Approve
  • Both A and B
  • A only
  • B only
  • Neither A nor B

  Reveal Answer Answer: B Next Question

• Question 4

  

  In 1999, the United States Congress passed the Financial Services Modernization Act, referred to as the Gramm-Leach-Bliley (GLB) Act. The primary provisions included under the GLB Act require financial institutions, including health plans, to take several

  • Notify customers of any sharing of non-public personal financial information with nonaffiliated third parties.
  • Prohibit customers from having the opportunity to 'opt-out' of sharing non-public personal financial information.
  • Disclose to affiliates, but not to third parties, their privacy policies regarding the sharing of nonpublic personal financial information.
  • Agree not to disclose personally identifiable financial information or personally identifiable health information.

  Reveal Answer Answer: A Next Question

• Question 5

  

  The Titanium Health Plan and a third-party administrator (TPA) have entered into a TPA agreement with regard to the administration of a particular health plan. This agreement complies with all of the provisions of the NAIC TPA Model Law. One of the TPA'sHold all funds it receives on behalf of Titanium in trust.Assume full responsibility for ensuring that the health plan is administered properlyObtain from the federal government a certificate of authority designating the organization as a TP

  • Assume full responsibility for determining the claim payment procedures for the plan

  Reveal Answer Answer: A Next Question

• Question 6

  

  Which of the following job descriptions best match the job of a telephone triage staff member?

  • Check patient vitals, write prescriptions, administer drugs.
  • Greet patients at the door, collect insurance information, schedule appointments, collect payments.
  • Determine urgency of the condition, notify emergency department, schedule appointments, authorize referrals, provide self-care information.
  • None of the above.

  Reveal Answer Answer: C Next Question

• Question 7

  

  Following a report by the Institute of Medicine on the incidence and consequences of medical errors, a national task force recommended implementation of a nationwide mandatory system of collecting, analyzing, and reporting standardized information about m

  • random change
  • structural change
  • haphazard change
  • reactive change

  Reveal Answer Answer: D Next Question

• Question 8

  

  In the following sections, we will describe some of the measures health plans use to evaluate the quality of the services and healthcare they offer their members.Which of the following is the best description of what a 'Process measure' evaluates?

  • The nature, quantity, and quality of the resources that a health plan has available for member service and patient care.
  • The methods and procedures a health plan and its providers use to furnish service and care.
  • The extent to which services succeed in improving or maintaining satisfaction and patient health.
  • None of the above

  Reveal Answer Answer: B Next Question

• Question 9

  

  Certificate of Authority (COA) is subject to:

  Reveal Answer Answer: B Next Question

• Question 10

  

  In order to help review its institutional utilization rates, the Sahalee Medical Group, a health plan, uses the standard formula to calculate hospital bed days per 1,000 plan members for the month to date (MTD). On April 20, Sahalee used the following inf

  • 67
  • 274
  • 365
  • 1,000

  Reveal Answer Answer: B Next Question

Page: 1 / 74
Total Questions: 367

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