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AHIP AHM-530 Exam Questions

Exam Name: Network Management
Exam Code: AHM-530
Related Certification(s): AHIP Network Management Certification
Certification Provider: AHIP
Actual Exam Duration: 120 Minutes
Number of AHM-530 practice questions in our database: 202 (updated: Mar. 30, 2025)
Expected AHM-530 Exam Topics, as suggested by AHIP :
  • Topic 1: Map out how health insurance providers select, contract with, and compensate specialists and health care facilities/ Learn the process for network provider selection
  • Topic 2: Recognize special requirements that affect network management for Medicare, Medicaid, and workers’ compensation networks
  • Topic 3: Gain a detailed understanding of the scope and organization of the network management function within health insurance provider organizations
  • Topic 4: Explore how health insurance providers ensure their provider networks remain adequate to meet member needs/ Understand how network strategies improve access, quality, and cost-effectiveness
  • Topic 5: Identify the primary responsibilities and obligations of health insurance providers and health care providers under a provider contract
  • Topic 6: Master the essential elements of a contractual relationship between health insurance providers and health care providers
Disscuss AHIP AHM-530 Topics, Questions or Ask Anything Related
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Eden

14 days ago
Cultural competency in network design was tested. Review strategies for ensuring diverse provider networks that meet community needs.
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Ellsworth

21 days ago
Nailed the AHIP certification thanks to Pass4Success. Their questions were right on target.
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Kara

29 days ago
Be ready for questions on network optimization. Understand how to analyze network performance and make data-driven decisions.
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Edwin

1 months ago
Pass4Success materials really helped with questions on provider relations. Know strategies for effective communication and conflict resolution.
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Lucia

2 months ago
AHIP exam conquered! Pass4Success's practice tests were key to my success.
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Curt

2 months ago
The exam included several questions on telemedicine integration. Study how virtual care impacts network design and access.
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Zack

2 months ago
I am happy to share that I passed the AHIP Network Management exam. Pass4Success practice questions were a big help. There was a question about Objective 6 that asked about the challenges of integrating new technologies into existing networks. I was unsure about the best strategies for integration, but I still passed.
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Harrison

2 months ago
Provider data management questions were challenging. Familiarize yourself with best practices for maintaining accurate provider directories.
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Merilyn

3 months ago
Successfully certified in AHIP Network Management. Pass4Success, you're the best for last-minute prep!
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Elouise

3 months ago
Network leasing agreements came up several times. Know the pros and cons, and how they affect network management strategies.
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Paris

3 months ago
Provider reimbursement models were a key focus. Understand the differences between fee-for-service, capitation, and value-based care.
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Ryan

3 months ago
Passing the AHIP Network Management exam was a great accomplishment for me. The practice questions from Pass4Success were very useful. One question that I found difficult was related to Objective 4, which asked about the different types of network management architectures. I wasn't confident about the pros and cons of each architecture, but I managed to pass.
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Carey

4 months ago
Passed AHIP Network Management! Pass4Success's questions were incredibly similar to the real thing.
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Rory

4 months ago
Thanks to Pass4Success, I was well-prepared for questions on regulatory compliance. Know your state and federal network requirements!
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Rachael

4 months ago
I successfully passed the AHIP Network Management exam, and Pass4Success practice questions were instrumental in my preparation. There was a question on Objective 7 that asked about the security measures in network management. I was unsure about the best practices for implementing these measures, but I still passed.
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Jules

4 months ago
Quality management in provider networks was heavily tested. Review performance metrics and how to implement improvement programs.
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Carri

4 months ago
The AHIP Network Management exam was tough, but I passed it with the help of Pass4Success practice questions. One question that puzzled me was about Objective 2, specifically the protocols used in network management. I wasn't entirely sure about the differences between SNMP and other protocols, but I managed to pass.
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Ty

5 months ago
AHIP certification achieved! Pass4Success made studying efficient and effective.
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Bong

5 months ago
Be prepared for scenario-based questions on network design. Understanding population health needs and geographic distribution is crucial.
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Kayleigh

5 months ago
I am thrilled to have passed the AHIP Network Management exam. The practice questions from Pass4Success were a great help. There was a question about Objective 3 that asked about the different types of network topologies. I was a bit unsure about the advantages of each topology, but I still passed.
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Van

5 months ago
Credentialing process questions caught me off guard. Know the steps involved and timelines for primary source verification. Pass4Success practice tests really helped here!
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Janna

5 months ago
Passing the AHIP Network Management exam was a significant achievement for me. Thanks to Pass4Success, I was well-prepared. One question that caught me off guard was related to Objective 5, focusing on the metrics used to evaluate network performance. I wasn't confident about the specific metrics, but I managed to pass.
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Lucy

6 months ago
Aced the AHIP exam! Pass4Success's materials were a lifesaver for quick prep.
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Hollis

6 months ago
Network adequacy was a big topic. Expect questions on access standards and how to measure network sufficiency. Brush up on CMS requirements!
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Derrick

6 months ago
The AHIP Network Management exam was challenging, but I made it through with the help of Pass4Success practice questions. There was a tricky question about Objective 1, which asked about the primary goals of network management. I was unsure about the exact prioritization of these goals, but I still succeeded.
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Maryanne

6 months ago
Just passed the AHIP Certified: Network Management exam! Questions on provider contracting were tricky. Focus on understanding different contract types and negotiation strategies.
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Leoma

6 months ago
I recently passed the AHIP Network Management exam, and it was quite a journey. The Pass4Success practice questions were incredibly helpful. One question that stumped me was about the key components of Objective 6, specifically regarding the integration of network management tools. I wasn't entirely sure about the best practices for tool integration, but I managed to pass the exam.
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Stevie

7 months ago
Just passed the AHIP Certified: Network Management exam! Thanks Pass4Success for the spot-on practice questions.
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Remona

7 months ago
Passing the AHIP Network Management exam was a great accomplishment for me. Thanks to Pass4Success practice questions, I felt well-prepared for topics such as workers' compensation networks. One question that I found particularly interesting was about the process of contracting with specialists. It required a thorough understanding of network management principles, but I was able to answer it confidently and pass the exam.
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Jina

8 months ago
My experience taking the AHIP Network Management exam was challenging but rewarding. With the assistance of Pass4Success practice questions, I was able to successfully navigate topics like network provider selection and management for Medicaid networks. One question that I remember from the exam was about the process of compensating specialists and healthcare facilities. It was a tricky one, but I was able to answer it correctly.
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Terrilyn

9 months ago
Just passed the AHIP Certified: Network Management exam! A key topic was provider credentialing. Expect questions on the steps and documentation required for this process. Study the timelines and regulatory requirements closely. Thanks to Pass4Success for the spot-on practice questions that helped me prepare efficiently!
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Laurel

9 months ago
I recently passed the AHIP Network Management exam with the help of Pass4Success practice questions. The exam covered topics such as provider selection, contracting, and compensation. One question that stood out to me was related to the special requirements for Medicare networks. I wasn't entirely sure of the answer, but I managed to pass the exam.
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Free AHIP AHM-530 Exam Actual Questions

Note: Premium Questions for AHM-530 were last updated On Mar. 30, 2025 (see below)

Question #1

The provider contract that Dr. Lorena Chau has with the Fiesta Health Plan includes an evergreen clause. The purpose of this clause is to:

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Correct Answer: C

Question #2

The Bruin Health Plan is a Social Health Maintenance Organization (SHMO). As an SHMO, Bruin:

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Correct Answer: A

Question #3

The Medicaid program subsidizes indigent care through payments to disproportionate share hospitals (DSHs). The Preamble Hospital is a DSH. As a DSH, Preamble most likely:

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Correct Answer: B

Question #4

When evaluating the success of providers in meeting standards, a health plan must make adjustments for case mix or severity. One true statement about case mix/severity adjustments is that they:

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Correct Answer: B

Question #5

The provider contract that the Canyon health plan has with Dr. Nicole Enberg specifies that she cannot sue or file any claims against a Canyon plan member for covered services, even if Canyon becomes insolvent or fails to meet its financial obligations. The contract also specifies that Canyon will compensate her under a typical discounted fee-for-service (DFFS) payment system.

During its recredentialing of Dr. Enberg, Canyon developed a report that helped the health plan determine how well she met Canyon's standards. The report included cumulative performance data for Dr. Enberg and encompassed all measurable aspects of her performance. This report included such information as the number of hospital admissions Dr. Enberg had and the number of referrals she made outside of Canyon's provider network during a specified period. Canyon also used process measures, structural measures, and outcomes measures to evaluate Dr. Enberg's performance.

Canyon used a process measure to evaluate the performance of Dr. Enberg when it evaluated whether:

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Correct Answer: A

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