Network Management

Here you have the best AHIP AHM-530 practice exam questions

  • You have 202 total questions to study from
  • Each page has 5 questions, making a total of 41 pages
  • You can navigate through the pages using the buttons at the bottom
  • This questions were last updated on November 14, 2025
  • This site is not affiliated with or endorsed by AHIP.
Question 1 of 202
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:
    Correct Answer: D

Question 2 of 202
The Avignon Company discontinued its contract with a traditional indemnity insurer and contracted exclusively with the Minaret Health Plan to provide the sole healthcare plan to Avignon's employees. By agreeing to an exclusive contract with Minaret, Avignon has entered into a type of healthcare contract known as:
    Correct Answer: C

Question 3 of 202
Federal laws--including the Ethics in Patient Referrals Act, the Health Maintenance Organization (HMO) Act of 1973, the Employee Retirement Income Security Act (ERISA), and the Federal Trade Commission Act-- have impacted the ways that health plans conduct business. For instance, the Mosaic Health Plan must comply with the following federal laws in order to operate:
Regulation 1: Mosaic must establish a mandated grievance resolution mechanism, including a method for members to address grievances with network providers.
Regulation 2: Mosaic must not allow its providers to refer Medicare and Medicaid patients to entities in which they have a financial or ownership interest.
From the answer choices below, select the response that correctly identifies the federal legislation on which Regulation 1 and Regulation 2 are based.
    Correct Answer: B

Question 4 of 202
In 1996, Congress passed the Health Insurance Portability and Accountability Act (HIPAA), which increased the continuity and portability of health insurance coverage. One statement that can correctly be made about HIPAA is that it:
    Correct Answer: C

Question 5 of 202
After HIPAA was enacted, Congress amended the law to include the Mental Health Parity Act (MHPA) of 1996, a federal requirement relating to mental health benefits. One true statement about the MHPA is that it:
    Correct Answer: D