Free AHIP AHM-520 Exam Questions

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

Page: 1 / 43

Total 215 Questions | Updated On: Mar 13, 2026

Add To Cart

Question 1

The following statements are about the Health Insurance Portability and Accountability Act (HIPAA) as it relates to the small group market. Three of these statements are true and one statement is false. Select the answer choice containing the FALSE statement.

A : A health plan that participates in the small group market is required to issue a contract to any employer that requests healthcare benefits, as long as the employer meets the statutory definition of a small group.

B : A small group must consist of more than 10 employees in order to be underwritten on a group, rather than an individual, basis.

C : A health plan is prohibited from canceling a small group’s healthcare coverage because of poor claims experience.

D : A health plan that participates in the small group market is limited in placing restrictions such as waiting periods and pre-existing conditions exclusions to individuals in high risk categories.

Answer: B

Question 2

The following statements are about the financial risks for health plans in Medicare and Medicaid markets. Three of these statements are true, and one statement is false. Select the answer choice containing the FALSE statement.

A : One reason that health plans in the Medicare and Medicaid markets experience financial risk is that government regulations determine which services must be provided to Medicare and Medicaid enrollees.

B : Effective use of hospital utilization is the single most likely factor to contribute to the success of a Medicare-contracting health plan.

C : If a Medicare-contracting health plan is a provider-sponsored organization (PSO), it is prohibited from sharing financial risk with its providers.

D : Typically, providers are more reluctant to accept financial risk in connection with providing services to the Medicaid population than with providing services to the Medicare population.

Answer: C

Question 3

Under GAAP, three approaches to expense recognition are generally allowed: associating cause and effect, systematic and rational allocation, and immediate recognition.

A health plan most likely would use the approach of systematic and rational allocation in order to:

A : Report the payment of the health plan's utility bills

B : Spread the payment of sales force commissions over the premium paying period of healthcare coverage

C : Report the fees paid by the health plan to attorneys and consultants

D : Depreciate the cost of a new computer system over the useful life of the system

Answer: D

Question 4

In the following paragraph, a sentence contains two pairs of words enclosed in parentheses. Determine which word in each pair correctly completes the sentence. Then select the answer choice containing the two words that you have selected.

Budgeting approaches can be classified as static or flexible budgets, or as rolling or period budgets. A health plan most likely would use a (static / flexible) budget when a budget's objective is to reduce or limit expenses, and the health plan most likely would use a (rolling / period) budget if it would like to continually maintain projections for a certain time period into the future.

A : static / rolling

B : static / period

C : flexible / rolling

D : flexible / period

Answer: A

Question 5

The Fairway health plan is a for-profit health plan that issues stock. The following data was taken from Fairway's financial statements:

Current assets.....$5,000,000 -

Total assets.....$6,000,000 -

Current liabilities.....$2,500,000

Total liabilities.....$3,600,000

Stockholders' equity.....$2,400,000

Fairway's total revenues for the previous financial period were $7,200,000, and its net income for that period was $180,000.

For the previous financial period, Fairway's net profit margin was:

A : 2.50%

B : 3.00%

C : 3.60%

D : 7.50%

Answer: A

Page: 1 / 43

Total 215 Questions | Updated On: Mar 13, 2026

Add To Cart