Free AHIP AHM-520 Exam Questions

Become AHIP Certified with updated AHM-520 exam questions and correct answers

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Total 215 Questions | Updated On: Feb 11, 2026

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Question 1

A health plan can use segment margins to evaluate the profitability of its profit centers.

One characteristic of a segment margin is that this margin:

A : Is the portion of the contribution margin that remains after a segment has covered its direct fixed costs

B : Incorporates only the costs attributable to a segment, but it does not incorporate revenues

C : Considers only a segment's costs that fluctuate in direct proportion to changes in the segment's level of operating activity

D : Evaluates the profit center's effective use of assets employed to earn a profit

Answer: A

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:

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 3

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

Question 4

In a fee-for-service (FFS) reimbursement method, providers are paid per treatment or per service that they provide.

One typical benefit of FFS reimbursement is that it:

A : Is highly effective in preventing excessive services that take the form of churning, unbundling, and upcoding

B : Provides physicians who attempt to control costs with a higher rate of compensation than is provided to physicians who make the effort to control costs

C : Is relatively easy to initiate, especially in markets where managed care penetration is low

D : Guards against the practice of defensive medicine

Answer: B

Question 5

The following statements are about 501(c)(9) trusts. Select the answer choice containing the correct statement:

A : In the event a 501(c)(9) trust is terminated, any funds remaining in the trust revert back to the employer.

B : In order to satisfy Internal Revenue Code (IRC) requirements, membership in a 501(c)(9) trust is mandatory for all employees.

C : Contributions made by an employer to a 501(c)(9) trust are deductible for federal income tax purposes.

D : Typically, a 501(c)(9) trust is controlled solely by the employer that established the trust.

Answer: C

Page: 1 / 43

Total 215 Questions | Updated On: Feb 11, 2026

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