Welcome to ExamTopics Pro
Facebook Twitter Youtube Pinterest

- Expert Verified, Online, Free.

MAIL US

info@examtopicspro.com

AHIP AHM-510 Exam Dumps

AHIP AHM-510 Exam Dumps

Certification Exams

Downloadable PDF versions

100% Confidential

Updated Regularly

Advanced Features

Number Of Questions

76

$ 39

Description

Exam Name: Governance, Legal Issues, Medicare and Medicaid
Exam Code: AHM-510 FAHM
Related Certification(s): AHIP Managed Healthcare Professional Certification
Certification Provider: AHIP
Actual Exam Duration: 90 Minutes
Number of AHM-510 practice questions in our database:
Expected AHM-510 Exam Topics, as suggested by AHIP :

  • Module 1: Review relevant terms, industry issues, case scenarios and concepts/ Understand the legal issues surrounding ERISA, pharmacy benefits, and wellness
  • Module 2: Dig deep into the role of health insurance providers in providing services to both Medicare and Medicaid enrollees/ Examine legal issues faced by health insurance providers in a post-reform environment
  • Module 3: Learn the role of the federal government as a purchaser of health care benefits/ Explore factors shaping the health insurance industry, its formation, types of insurance, and structure
  • Module 4: Delve into federal and state regulatory requirements that affect health insurance providers/ Analyze how fraud and abuse affect health care’s cost and quality
  • Module 5: Explore how health insurance providers use organizational control systems to build internal structures that meet external demands for accountability
  • Module 6: Understand how health insurance providers use reorganization, reengineering, and strategic planning to improve performance

Description

Exam Name: Governance, Legal Issues, Medicare and Medicaid
Exam Code: AHM-510 FAHM
Related Certification(s): AHIP Managed Healthcare Professional Certification
Certification Provider: AHIP
Actual Exam Duration: 90 Minutes
Number of AHM-510 practice questions in our database:
Expected AHM-510 Exam Topics, as suggested by AHIP :

  • Module 1: Review relevant terms, industry issues, case scenarios and concepts/ Understand the legal issues surrounding ERISA, pharmacy benefits, and wellness
  • Module 2: Dig deep into the role of health insurance providers in providing services to both Medicare and Medicaid enrollees/ Examine legal issues faced by health insurance providers in a post-reform environment
  • Module 3: Learn the role of the federal government as a purchaser of health care benefits/ Explore factors shaping the health insurance industry, its formation, types of insurance, and structure
  • Module 4: Delve into federal and state regulatory requirements that affect health insurance providers/ Analyze how fraud and abuse affect health care’s cost and quality
  • Module 5: Explore how health insurance providers use organizational control systems to build internal structures that meet external demands for accountability
  • Module 6: Understand how health insurance providers use reorganization, reengineering, and strategic planning to improve performance

Reviews

There are no reviews yet.

Be the first to review “AHIP AHM-510 Exam Dumps”

Your email address will not be published. Required fields are marked *

Q1. The Westchester Health Plan is using a pricing strategy that involves setting a low price in a highly price-sensitive market to stimulate revenue growth. In following this strategy, Westchester is sacrificing short-term profits for fast growth in selected markets. This information indicates that Westchester is following the pricing strategy known as

A.Market skimming

B. Buying market share

C. Price skimming

D. Unitary pricing

Correct Answer: B

Q2. In examining accountability in the current managed care environment, one is likely to find that combinations of various models of accountability are in operation. Under one model of accountability, the primary mechanisms for accountability are the mechanisms of the marketplace failure to meet standards will result in a loss of demand for services. By definition, this model of accountability is called the

A.Professional model of accountability

B. Political model of accountability

C. Due diligence model of accountability

D. Economic model of accountability

Correct Answer: D

Q3. SoundCare Health Services, a health plan, recently conducted a situation analysis. One step in this analysis required SoundCare to examine its current activities, its strengths and weaknesses, and its ability to respond to potential threats and opportunities in the environment. This activity provided SoundCare with a realistic appraisal of its capabilities. One weakness that SoundCare identified during this process was that it lacked an effective program for preventing and detecting violations of law. SoundCare decided to remedy this weakness by using the 1991 Federal Sentencing Guidelines for Organizations as a model for its compliance program. With respect to the Federal Sentencing Guidelines, actions that SoundCare should take in developing its compliance program include

A.Creating a system through which employees and other agents can report suspected misconduct without fear of retribution

B. Holding management accountable for the misconduct of their subordinates

C. Assigning a high-level member of management to the position of compliance coordinator or administrator

D. All of the above

Correct Answer: D

Q4. The Hanford Health Plan has delegated the credentialing of its providers to the Sienna Group, a credential verification organization (CVO). If the contract between Hanford and Sienna complies with all of the National Committee for Quality Assurance (NCQA) guidelines for delegation of credentialing, then this contract

A.Transfers to Sienna all rights to terminate or suspend individual practitioners or providers in Hanford's provider network

B. Describes the process by which Hanford evaluates Sienna's performance in credentialing providers

C. Both A and B

D. A only

E. B only

F. Neither A nor B

Correct Answer: C

$ 39

Frequently Asked Questions

ExamTopics Pro is a premium service offering a comprehensive collection of exam questions and answers for over 1000 certification exams. It is regularly updated and designed to help users pass their certification exams confidently.
Please contact team@examtopics.com and we will provide you with alternative payment options.
The subscriptions at Examtopics.com are recurring according to the Billing Cycle of your Subscription Plan, i.e. after a certain period of time your credit card is re-billed automatically until/unless you cancel your subscription.
Free updates are available for the duration of your subscription, after the subscription is expired, your access will no longer be available.

Get IT Certification

Unlock free, top-quality video courses on ExamTopicspro with a simple registration. Elevate your learning journey with our expertly curated content. Register now to access a diverse range of educational resources designed for your success. Start learning today with ExamTopicspro!

Start Learning for free

Social Media

Facebook, linkedin, YouTube, Reddit, Pinterest

Email Address

info@examtopicspro.com
www.examtopicspro.com

We are the biggest and most updated IT certification exam material website.

Using our own resources, we strive to strengthen the IT professionals community for free.

SiteMAP
Recent Articles
Facebook Linkedin Youtube Reddit Pinterest

© 2025 ExamTopics Pro