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AHIP AHM-520 Exam Questions

Exam Name: Health Plan Finance and Risk Management
Exam Code: AHM-520 FAHM
Related Certification(s): AHIP Managed Healthcare Professional Certification
Certification Provider: AHIP
Actual Exam Duration: 90 Minutes
Number of AHM-520 practice questions in our database: 215 (updated: Apr. 21, 2025)
Expected AHM-520 Exam Topics, as suggested by AHIP :
  • Topic 1: Recognize different reserving methodologies used by health insurance providers/ Analyze the role of strategic financial planning in setting a health insurance provider’s future direction
  • Topic 2: Learn about the financial risks for health insurance provider organizations that provide health care services to Medicare and/or Medicaid populations compared to risks within the commercial population
  • Topic 3: Discover how to identify claim related components of health insurance providers’ financial statements
  • Topic 4: Gain an understanding of risk, decisions regarding risk assumption, and how health insurance providers control risk
  • Topic 5: Distinguish between fully funded and self-funded plans and the increasing role of self-funding in the marketplace
  • Topic 6: Compare the difference between stop-loss insurance and stop-loss reinsurance from the perspective of health insurance providers
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Arletta

12 days ago
Just became AHIP certified! Pass4Success was crucial for my success. Their exam questions were incredibly helpful.
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Oretha

19 days ago
The exam covers reinsurance in health insurance. Know the types of reinsurance and when they're typically used by health plans.
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Trinidad

1 months ago
Questions on value-based care models appeared. Study different VBC frameworks and their financial implications for health plans.
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Reita

1 months ago
Just passed the AHIP Health Plan Finance exam! Thanks Pass4Success for the spot-on practice questions.
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Xenia

2 months ago
Successfully completed the exam! Be prepared for questions on capitation arrangements. Understand the risks and benefits for both payers and providers.
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Stephanie

2 months ago
The exam tests knowledge of healthcare cost trends. Be familiar with factors driving medical cost inflation and mitigation strategies.
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Jolene

2 months ago
Thanks to Pass4Success, I aced the AHIP exam! Their questions were perfect for last-minute preparation.
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Gussie

3 months ago
Pass4Success really helped with questions on reserve estimation techniques. Understand the methods for calculating IBNR reserves.
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Raul

3 months ago
Just passed the AHIP exam! The Pass4Success practice questions were a great help. One tricky question was about the different types of provider payment methods and their impact on health plan costs. I wasn't completely confident, but I made it through.
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Craig

3 months ago
Expect to interpret financial statements specific to health plans. Practice analyzing balance sheets and income statements for insurers.
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Cassi

3 months ago
AHIP Health Plan Finance exam: check! Pass4Success made it possible with their concise and relevant study materials.
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Cassi

4 months ago
Passed with flying colors! Questions on underwriting practices were prevalent. Know the legal and ethical considerations in health plan underwriting.
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Amira

4 months ago
I passed the AHIP Health Plan Finance and Risk Management exam, thanks to Pass4Success. One question that was particularly difficult asked about the various types of financial risk in health plans and how they are managed. I wasn't entirely sure of my answer, but I still passed.
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Vicente

4 months ago
The exam covers risk-based capital requirements. Study the RBC formula and its implications for health plan financial management.
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Grover

4 months ago
Passed my AHIP certification! Pass4Success provided exactly what I needed to prepare efficiently. Highly recommend!
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Paris

5 months ago
Happy to report that I passed the AHIP exam. The Pass4Success practice questions really helped. There was a challenging question about the different methods of premium rate setting and their implications. I was a bit uncertain, but I managed to pass.
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Hui

5 months ago
Be ready to analyze scenarios related to provider reimbursement models. Understand the pros and cons of different payment structures.
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Royal

5 months ago
I just passed the AHIP Health Plan Finance and Risk Management exam! The Pass4Success practice questions were invaluable. One question that gave me pause was about the principles of underwriting and how they apply to different types of health plans. I wasn't sure about the specifics, but I got through it.
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Aileen

5 months ago
Thanks to Pass4Success, I felt well-prepared for questions on financial solvency regulations. Know the key ratios and regulatory bodies involved.
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Gwen

5 months ago
Wow, that AHIP exam was tough! Grateful for Pass4Success - their questions really matched the actual test.
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Celeste

6 months ago
Passed the AHIP exam, and I couldn't have done it without Pass4Success. There was a particularly tough question on the exam about the various types of health plan reserves and their purposes. I wasn't entirely confident in my answer, but I still managed to pass.
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Carey

6 months ago
The exam tests understanding of actuarial principles in premium setting. Review factors influencing premium rates and pricing strategies.
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Mariko

6 months ago
I am thrilled to share that I passed the AHIP Health Plan Finance and Risk Management exam. The Pass4Success practice questions were spot on. One challenging question asked about the key components of a health plan's financial statement. I had to think hard about the differences between assets and liabilities.
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Lai

6 months ago
Expect calculations involving medical loss ratio (MLR). Study the components and regulatory requirements for MLR reporting.
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Art

6 months ago
AHIP certification achieved! Couldn't have done it without Pass4Success. Their materials were spot-on for quick prep.
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Kirk

7 months ago
Just finished the AHIP exam and passed! The Pass4Success practice questions were a lifesaver. There was a tricky question about the different types of risk management strategies, specifically focusing on the differences between hedging and insurance. I was a bit unsure, but I still managed to pass.
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Raina

7 months ago
Just passed the AHIP Certified: Health Plan Finance and Risk Management exam! Grateful for Pass4Success's relevant practice questions. Be prepared for questions on risk adjustment methodologies in health insurance.
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Glory

7 months ago
I recently passed the AHIP Health Plan Finance and Risk Management exam, and I must say, the Pass4Success practice questions were incredibly helpful. One question that stumped me was about the methods for calculating risk-adjusted return on capital. I wasn't entirely sure which method was most appropriate in a given scenario, but I managed to get through it.
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Stevie

7 months ago
Just passed the AHIP Health Plan Finance exam! Pass4Success was a lifesaver with their relevant practice questions. Thanks!
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Corrina

8 months ago
Passing the AHIP Health Plan Finance and Risk Management exam was a significant achievement for me, and I attribute my success to the practice questions provided by Pass4Success. The exam covered topics such as different reserving methodologies used by health insurance providers and the financial risks for health insurance provider organizations that provide health care services to Medicare and/or Medicaid populations. One question that I recall from the exam was related to the strategic financial planning in setting a health insurance provider's future direction. Despite my uncertainty about the answer, I managed to pass the exam.
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Franchesca

9 months ago
Thrilled to have passed the AHIP exam! A major focus was on actuarial concepts in health insurance. Expect questions on premium rate setting and reserving methods. Brush up on your understanding of medical loss ratios and their calculations. The exam also tested knowledge of value-based care models and their financial impacts. Pass4Success's practice tests were spot-on – they definitely fast-tracked my exam readiness!
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Marva

9 months ago
My experience taking the AHIP Health Plan Finance and Risk Management exam was challenging but rewarding. With the assistance of Pass4Success practice questions, I was able to successfully pass the exam. One question that I remember from the exam was about analyzing the role of strategic financial planning in setting a health insurance provider's future direction. Although I had some doubts about my answer, I was able to overcome them and pass the exam.
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Yuki

9 months ago
Successfully completed the AHIP Risk Management certification! Be prepared for scenarios on identifying and mitigating various types of health plan risks. Understanding reinsurance concepts is crucial. The exam also covered regulatory compliance – know key healthcare laws and their financial implications. Pass4Success's exam questions were invaluable for my quick preparation. So grateful for their help!
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Jannette

10 months ago
Just passed the AHIP Health Plan Finance exam! A key focus was on risk adjustment methodologies. Expect questions on HCC coding and its impact on revenue. Study the different risk adjustment models thoroughly. Thanks to Pass4Success for the spot-on practice questions that helped me prepare efficiently!
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Dianne

10 months ago
I recently passed the AHIP Health Plan Finance and Risk Management exam with the help of Pass4Success practice questions. The exam covered topics such as different reserving methodologies used by health insurance providers and the role of strategic financial planning in setting a health insurance provider's future direction. One question that stood out to me was related to the financial risks for health insurance provider organizations that provide health care services to Medicare and/or Medicaid populations compared to risks within the commercial population. Despite being unsure of the answer, I managed to pass the exam.
upvoted 0 times
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Tish

10 months ago
Just passed the AHIP Health Plan Finance exam! A key topic was risk adjustment models. Expect questions on HCC coding and its impact on revenue. Study the different risk adjustment methodologies. The exam also focused on financial forecasting techniques. Practice interpreting financial statements and projecting future costs. Thanks to Pass4Success for the spot-on practice questions – they really helped me prepare efficiently!
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Free AHIP AHM-520 Exam Actual Questions

Note: Premium Questions for AHM-520 were last updated On Apr. 21, 2025 (see below)

Question #1

Health plans seeking to provide comprehensive healthcare plans must contract with a variety of providers for ancillary services. One characteristic of ancillary services is that

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Correct Answer: D

Question #2

The Fiesta Health Plan prices its products in such a way that the rates for its products are reasonable, adequate, equitable, and competitive. Fiesta is using blended rating to calculate a premium rate for the Murdock Company, a large employer. Fiesta has assigned a credibility factor of 0.6 to Murdock. Fiesta has also determined that Murdock's manual rate is $200 PMPM and that Murdock's experience rate is $180 PMPM.

According to regulations, Fiesta's premium rates are reasonable if they

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Correct Answer: D

Question #3

The Amethyst Health Plan uses a budgeting approach that requires each line of business within Amethyst's operation to justify its continued operation. Amethyst begins with the premise that no resources will be allocated for the following period unless each dollar to be spent is justified and is shown to be within departmental plans and corporate goals and objectives. The budgeting approach used by Amethyst is known as:

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Correct Answer: C

Question #4

The following statements are about various reimbursement arrangements that health plans have with hospitals. Select the answer choice containing the correct statement.

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Correct Answer: C

Question #5

Costs that can be defined by behavior are most commonly classified as fixed costs, variable costs and semi-variable costs. Examples of fixed costs include:

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Correct Answer: A

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