Free AHIP AHM-540 Exam Questions

Become AHIP Certified with updated AHM-540 exam questions and correct answers

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Total 165 Questions | Updated On: Jan 04, 2026
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Question 1

Examples of alternative healthcare practitioners are chiropractors, naturopaths, and acupuncturists. The only well-established credentialing standards for alternative healthcare practitioners are those available from NCQ A. These NCQA credentialing standards apply to 


Answer: A
Question 2

A health plan’s coverage policies are linked to its purchaser contracts. The following statement(s) can correctly be made about the purchaser contract and coverage decisions: 1. In case of conflict between the purchaser contract and a health plan’s medical policy or benefits administration policy, the contract takes precedence 2. Purchaser contracts commonly exclude custodial care from their coverage of services and supplies 3. All of the criteria for coverage decisions must be included in the purchaser contract  


Answer: B
Question 3

Benchmarking is a quality improvement strategy used by some health plans. With regard to benchmarking, it is correct to say that 


Answer: D
Question 4

The following statement(s) can correctly be made about the scope of case management:1. Case management incorporates activities that may fall outside a health plan’s typicalresponsibilities, such as assessing a member’s financial situation2. Case management generally requires a less comprehensive and complex approach to a courseof care than does utilization review3. Case management is currently applicable only to medical conditions that require inpatienthospital care and are categorized as catastrophic in terms of health and/or costs 


Answer: D
Question 5

Health plans arrange for the delivery of various levels of healthcare, including1. Emergency care2. Urgent care3. Primary care delivered in a provider’s officeIn a ranking of these levels of care according to cost, beginning with the least expensive level ofcare and ending with the most expensive level of care, the correct order would be 


Answer: D
Page:    1 / 33      
Total 165 Questions | Updated On: Jan 04, 2026
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