AHIP Health Plan Finance and Risk Management - AHM-520 Exam Practice Test
Dr. Martin Cassini is an obstetrician who is under contract with the Bellerby Health Plan. Bellerby compensates Dr. Cassini for each obstetrical patient he sees in the form of a single amount that covers the costs of prenatal visits, the delivery itself, and post-delivery care . This information indicates that Dr. Cassini is compensated under the provider reimbursement method known as a:
Correct Answer: D
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In order to determine a health plan's quick liquidity ratio, a financial analyst would divide the health plan's
Correct Answer: C
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For a given healthcare product, the Magnolia Health Plan has a premium of $80 PMPM and a unit variable cost of $30 PMPM. Fixed costs for this product are $30,000 per month. Magnolia can correctly calculate the break-even point for this product to be:
Correct Answer: A
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Many clinicians are concerned about the development of practice guidelines that seek to define appropriate healthcare services that should be provided to a patient who has been diagnosed with a specific condition. To avoid the risk associated with using such guidelines, health plans should advise clinicians that the existence of such a guideline:
1.Establishes standards of care to be routinely utilized with all patients presenting a specific condition
2.Preempts a physician's judgment when assessing the specific factors related to a patient's condition
1.Establishes standards of care to be routinely utilized with all patients presenting a specific condition
2.Preempts a physician's judgment when assessing the specific factors related to a patient's condition
Correct Answer: C
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Dr. Jacob Winburne is compensated by the Honor Health Plan under an arrangement in which Honor establishes at the beginning of a financial period a fund from which claims approved for payment are paid. At the end of the given period, any funds remaining are
paid out to providers. This information indicates that the arrangement between Dr. Winburne and Honor includes a provider incentive known as a:
paid out to providers. This information indicates that the arrangement between Dr. Winburne and Honor includes a provider incentive known as a:
Correct Answer: B
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The following statement(s) can correctly be made about a health plan's cash receipts and cash disbursements budgets:
Correct Answer: C
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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
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
Correct Answer: C
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The Kayak Company self funds the health plan for its employees. This plan is an example of a type of self-funded plan known as a general asset plan. The fact that this is a completely self-funded plan indicates that
Correct Answer: C
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Costs that can be defined by behavior are most commonly classified as fixed costs,
variable costs, and semi-variable costs. From the following answer choices, select the response that correctly indicates a fixed cost and a variable cost for a health plan.
variable costs, and semi-variable costs. From the following answer choices, select the response that correctly indicates a fixed cost and a variable cost for a health plan.
Correct Answer: D
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The Wallaby Health Plan purchased an asset two years ago for $50,000. At the time of purchase, the asset had an appraised value of $52,000. The asset carries a value on Wallaby's general ledger of $47,000, and its current market value is $80,000. According to the cost concept, Wallaby would report on its financial statements a value for this asset equal to:
Correct Answer: A
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If Grace Wilson is eligible for benefits under both the Medicare and Medicaid programs, then
Correct Answer: B
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