Healthcare Management: An Introduction (AHM-250) - AHIP Actual Exam Questions
Last updated on April 11, 2026
Which of the following is NOT a preventive care initiative often used by health plans?
Screening for high blood pressure
Maternity management programs
Vaccines
Physical therapy
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Katrina Lopez is a claims analyst for a health plan that provides a higher level of benefits for services received in-network than for services received out-of-network. Ms. Lopez reviewed a health claim for answers to the following questions: Question A
A, B, C, and D
A, B, and D only
B, C, and D only
A and C only
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Eleanor Giambi is covered by a typical 24-hour managed care program. One characteristic of this program is that it:
Provides Ms. Giambi with healthcare coverage for any illness or injury, but only if the cause of the illness or injury is work-related.
Combines the group health plan and disability plan offered by Ms. Giambi's employer with workers' compensation coverage.
Requires Ms. Giambi and her employer to each pay half of the cost of this coverage.
Requires Ms. Giambi to pay specified deductibles and copayments before receiving benefits under this program for any illness or injury.
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Health plans use the following to determine the number of providers to add to a network:
Staffing ratios
Drive time
Geographic availability
All of the above
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One distinguishing characteristic of a health maintenance organization (HMO) is that, typically, an HMO
arranges for the delivery of medical care and provides, or shares in providing, the financing of that care
must be organized on a not-for-profit basis
may be organized as a corporation, a partnership, or any other legal entity
must be federally qualified in order to conduct business in any state
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