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With every one of the populace in India growing to earlier mentioned one particular.two billion folks, furthermore, it seems to be the perfect breeding ground for poverty, malnutrition, and issue in the whole entire world. India has the most AHIP effective selection of minor just one laborers inside the globe. In excess of 350 million younger little ones underneath the age of fourteen haven’t been to your faculty. Poverty and overpopulation are twin difficulties obtrusive with all the FAHM AHIP AHM-530 Study Network Management Indian AHIP political application.

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AHIP AHM-530 Exam Sample Questions

Question: 5

Network managers rely on a health plan’s claims administration department for much of the information needed to manage the performance of providers who are not under a capitation arrangement. Examining claims submitted to a health plan’s claims administration department enables the health plan to

  1. determine the number of healthcare services delivered to plan members
  2. monitor the types of services provided by the health plan’s entire provider network
  3. evaluate providers’ practice patterns and compliance with the health plan’s procedures for the delivery of care
  4. all of the above


Answer: D

Question: 2

Decide whether the following statement is true or false:

The organizational structure of a health plan’s network management function often depends on the size and geographic scope of the health plan. With respect to the size of a health plan, it is correct to say that smaller health plans typically have less integration and more specialization of roles than do larger health plans.

  1. True
  2. False


Answer: B

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Question: 1

By definition, a measure of the extent to which a health plan member can obtain necessary medical services in a timely manner is known as

  1. Network management
  2. Quality
  3. Cost-effectiveness
  4. Accessibility


Answer: D

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Question: 2

Decide whether the following statement is true or false:

The organizational structure of a health plan’s network management function often depends on the size and geographic scope of the health plan. With respect to the size of a health plan, it is correct to say that smaller health plans typically have less integration and more specialization of roles than do larger health plans.

  1. True
  2. False


Answer: B

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Question: 5

Network managers rely on a health plan’s claims administration department for much of the information needed to manage the performance of providers who are not under a capitation arrangement. Examining claims submitted to a health plan’s claims administration department enables the health plan to

  1. determine the number of healthcare services delivered to plan members
  2. monitor the types of services provided by the health plan’s entire provider network
  3. evaluate providers’ practice patterns and compliance with the health plan’s procedures for the delivery of care
  4. all of the above


Answer: D

Question: 2

Decide whether the following statement is true or false:

The organizational structure of a health plan’s network management function often depends on the size and geographic scope of the health plan. With respect to the size of a health plan, it is correct to say that smaller health plans typically have less integration and more specialization of roles than do larger health plans.

  1. True
  2. False


Answer: B