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AHIP AHM-250 Exam
- AHIP Healthcare Management: An Introduction Certifications
- AHIP Managed Healthcare Professional Certifications
- Topic 1: Review relevant terms, industry issues, care scenarios, and concepts/ Understand the basic concepts of health insurance provider organizations
- Topic 2: Delve into legislative and regulatory issues affecting the health insurance industry, including the Affordable Care Act (ACA) and the 21st Century Cures Act
- Topic 3: Understand role of government-sponsored programs, including Medicare and Medicaid, in providing coverage to large segments of the population
- Topic 4: Explore the concepts of rating, underwriting, and claims administration in health insurance provider environments/ Recognize HSAs? and HRAs? roles in today?s consumer-centric environment
- Topic 5: Examine the interplay of information technology with essential functions of health insurance provider operations/ Distinguish among HMOs, PPOs, POSs, and managed indemnity
- Topic 6: Gain a practical understanding of the evolution of health care delivery and financing in the United States, from pre-paid plans to ACOs
- Topic 7: Learn the importance of network structure and management in delivering quality healthcare/ Identify different types of health insurance provider organizations
Free AHIP AHM-250 Exam Actual Questions
Note: Premium Questions for AHM-250 were last updated On May. 06, 2024 (see below)
The following statements are about the various Health Plan Accountability Models adopted by the NAIC.
The National Association of Insurance Commissioners (NAIC) developed the Small Group Model Act to enable small groups to obtain accessible, yet affordable, group health benefits. The model law limits the rate spread, which is the difference between the highest and lowest rates that a health plan charges small groups, to a particular ratio.
According to the Model Act, for example, if the lowest rate an HMO charges a small group for a given set of medical benefits is $40, then the maximum rate the HMO can charge for the same set of benefits is
Disease management is typically set up as a voluntary outreach and support program for plan members with certain _________ diseases
The scandent Health Group contracted with the Empire Corporation to provide behavioral healthcare services to.
Empire employees. As a condition of providing behavioral healthcare services, scandent required Empire to contract with scandent for basic medical services scandent's actions constituted the type of antitrust violation known as a
Disease management is typically set up as a voluntary outreach and support program for plan members with certain _________ diseases
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