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AHM-520 Exam Dumps : Health Plan Finance and Risk Management

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Health Plan Finance and Risk Management Questions and Answers

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Question 1

One difference between the internal and external analysis of a health plan's financial information is that

Options:

A.

Internal analysis of the health plan can be more detailed and more specific than can external analysis

B.

Internal analysts are more likely than external analysts to want comparative financial data about the health plan

C.

Only internal analysts use trend analysis to analyze the health plan's financial statements

D.

Only internal analysts typically conduct the financial analysis of the health plan themselves

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Question 2

The physicians who work for the Sunrise Health Plan, a staff model HMO, are paid a salary that is not augmented with another type of incentive plan. Compared to the use of a traditional reimbursement method, Sunrise's use of a salary reimbursement method is more likely to

Options:

A.

Encourage Sunrise's physicians to perform services that are not medically necessary

B.

Completely eliminate service risk for Sunrise's physicians

C.

Decrease Sunrise's liability for any negligent acts of the physicians in the plan's network of providers

D.

Help stabilize expenses for Sunrise

Question 3

The Jamal Health Plan operates in a state that mandates that a health plan either allow providers to become part of its network or reimburse those providers at the health plan’s negotiated-contract rate, so long as the non-contract provider is willing to perform the services at the contract rate. This type of law is known as:

Options:

A.

A fair procedure law

B.

A direct access law

C.

An any willing provider law

D.

A due process law

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