Free AHM-520 Exam Braindumps

- (Topic 1)
The Harp Company self-funds the health plan for its employees. The plan is administered under a typical administrative-services-only (ASO) arrangement. One true statement about this ASO arrangement is that

1. A. This arrangement prevents Harp from purchasing stop-loss coverage for its health plan
2. B. The amount that Harp pays the administrator to provide the ASO services is not subject to state premium taxes
3. C. The administrator is responsible for paying claims from its own assets if Harp's account is insufficient
4. D. The charges for the ASO services must be stated as a percentage of the amount of claims paid for medical expenses incurred by Harp's covered employees and their dependents

Correct Answer: B

- (Topic 1)
The following statements are about carve-out programs. Three of these statements are true, and one statement is false. Select the answer choice containing the FALSE statement.

1. A. In the type of carve-out in which entire categories of care are administered by independent organizations, a health plan typically reimburses these organizations under an FFS contract.
2. B. Typically, a health plan will offer carved-out services to its enrollees, but will manage these services separately.
3. C. Carve-outs are services that are excluded from a capitation payment, a risk pool, or a health benefit plan.
4. D. The most rapidly growing area related to carve-outs is disease management (DM).

Correct Answer: A

- (Topic 1)
Providing services under Medicare or Medicaid can impose on health plans financial risks and costs that are greater than those related to providing services to the commercial population. Reasons that an health plan's financial risks and costs for providing services to Medicare and Medicaid enrollees tend to be higher include

1. A. Most Medicare and Medicaid enrollees can disenroll from a health plan on a monthly basis
2. B. The high incidences of chronic illness in both the Medicare and Medicaid populations results in higher costs related to coordinating care and case management
3. C. Medicare and Medicaid enrollees tend to have a high level of costs in the first few months of enrollment as the health plan educates them about the health plan system and performs initial health screening to evaluate their health
4. D. all of the above

Correct Answer: D

- (Topic 1)
For this question, select the answer choice containing the terms that correctly complete blanks A and B in the paragraph below. The FASB mandates that accounting information must exhibit certain qualitative characteristics. One of these characteristics is ______ A _______, which means that a company's financial statements use the same accounting policies and procedures from one accounting period to the next, unless there is a sound reason for changing a policy or procedure. Another characteristic is ______ B _______, which requires a company to disclose in its financial statements all significant financial information about the company.

1. A. A = reliability B = comparability
2. B. A = reliability B = materiality
3. C. A = consistency B = comparability
4. D. A = consistency B = materiality

Correct Answer: D

- (Topic 2)
The following information was presented on one of the financial statements prepared by the Rouge Health Plan as of December 31, 1998:

This type of financial statement is called:

1. A. A balance sheet
2. B. An income statement
3. C. A statement of owners’ equity
4. D. A cash flow statement

Correct Answer: C