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Healthcare Management: An Introduction (AHM-250) - AHIP Exam Questions

Last updated on June 20, 2026

97% Exam Compliance
367 Total Questions
1
Question
The Koster Company plans to purchase a health plan for its employees from Intuitive HMO. Intuitive will administer the plan and will bear the responsibility of guaranteeing claim payments by paying all incurred covered benefits. Koster will pay for the he
Options
A stop-loss plan
B self-funded plan
C fully funded plan
D self-pay plan
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2
Question
The Oriole MCO uses a typical diagnosis-related groups (DRGs) payment method to reimburse the Isle Hospital for its treatment of Oriole members. Under the DRG payment method, whenever an Oriole member is hospitalized at Isle, Oriole pays Isle
Options
A a fixed rate based on average expected use of hospital resources in a given geographical area for that DRG
B a specific negotiated amount for each day the Oriole member is hospitalized
C an amount based on the weighted value of each medical procedure or service that Isle provides,
and the weighted value is determined by the appropriate current procedural terminology (CPT) code
for the procedure or service
D a retrospective reimbursement based on the actual costs of the Oriole member's hospitalization
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3
Question
For this question, select the answer choice containing the terms that correctly complete the blanks
labeled A and B in the paragraph below. NCQA offers Quality Compass, a national database of performance and accreditation information submitted by managed
Options
A Health Plan Employer Data and Information Set (HEDIS) voluntary
B ORYX voluntary
C Health Plan Employer Data and Information Set (HEDIS) mandatory
D ORYX mandatory
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4
Question
The Fairway Health Group contracted with the Empire Corporation to provide behavioral healthcare services to Empire employees. As a condition of providing behavioral healthcare services, Fairway required Empire to contract with Fairway for basic medical s
Options
A price-fixing agreement
B tying arrangement
C horizontal group boycott
D horizontal division of markets
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5
Question
The Hill Health Plan designed a set of benefits that it packaged in the form of a PPO product. Hill then established a pricing structure that allowed its product to compete in the small group market, and it developed advertising designed to inform potential
Options
A A self-funded plan
B A fully funded plan
C An indemnity wraparound plan
D An aggregate stop-loss plan
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