Free AHIP AHM-530 Exam Questions

Become AHIP Certified with updated AHM-530 exam questions and correct answers

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Total 205 Questions | Updated On: Sep 22, 2026

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Question 1

The Walnut Health Plan provides a number of specialty services for its members. Walnut offers coverage of alternative healthcare, including coverage of treatment methods such as homeopathy and naturopathy. Walnut also offers home healthcare services, and it contracts with home healthcare providers on a non-risk basis to the health plan. The following statements are about the specialty services offered by Walnut. Select the answer choice containing the correct statement:

A : Homeopathy treats diseases by using small doses of substances which, in healthy people, are capable of producing symptoms like those of the disease being treated.

B : Naturopathy is an approach to healthcare that uses electronic monitoring devices to teach a patient to develop conscious control of involuntary bodily functions, such as heart rate.

C : Under a non-risk contract, Walnut most likely transfers the responsibility for arranging home healthcare to the home healthcare provider organizations.

D : Federal law allows Walnut to contract with a home healthcare provider organization only if the provider organization has received accreditation by the Utilization Review Accreditation Commission (URAC).

Answer: A

Question 2

With respect to contractual provisions related to provider-patient communications, nonsolicitation clauses prohibit providers from

A : Encouraging patients to switch from one health plan to another

B : Disclosing confidential information about the health plan’s reimbursement structure

C : Dispersing confidential financial information regarding the health plan

D : Discussing alternative treatment plans with patients

Answer: A

Question 3

The following statements are about workers' compensation provider networks. Select the answer choice containing the correct statement:

A : In order to supply a provider network to furnish healthcare to workers' compensation beneficiaries, a health plan typically uses the network that has already been created for the group health plan.

B : Typically, case managers for workers' compensation programs are physical therapists.

C : Most states prohibit the use of fee schedules in order to curb the rising workers' compensation healthcare costs.

D : Networks serving workers' compensation patients typically include higher concentrations of specialists than do other provider networks.

Answer: D

Question 4

A population’s demographic factors—such as income levels, age, gender, race, and ethnicity—can influence the design of provider networks serving that population. With respect to these demographic factors, it is correct to say that

A : higher-income populations have a higher incidence of chronic illnesses than do lowerincome populations

B : compared to other groups, young men are more likely to be attached to particular providers

C : a population with a high proportion of women typically requires more providers than does a population that is predominantly male

D : Health plans should not recognize, in either the design of networks or the evaluation of provider performance, racial and ethnic differences in the member population

Answer: C

Question 5

The following statement(s) can correctly be made about hospitalists.1. The hospitalist’s main function is to coordinate diagnostic and treatment activities to ensure thatthe patient receives appropriate care while in the hospital.2. The hospitalist’s role clearly supports the health plan concept of disease management.

A : Both 1 and 2

B : 1 only

C : 2 only

D : Neither 1 nor 2

Answer: B

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Total 205 Questions | Updated On: Sep 22, 2026

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