Practice AHM-530 Exam Online

Question 1

The following paragraph contains an incomplete statement. Select the answer choice containing the term that correctly completes the statement. One important activity within the scope of network management is ensuring the quality of the health plan’s provider networks. A primary purpose of __ __ is to review the clinical competence of a provider in order to determine whether the provider meets the health plan’s preestablished criteria for participation in the network.

A : authorization

B : provider relations

C : credentialing

D : utilization management

Answer: C

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

Dr. Eve Barlow is a specialist in the Amity Health Plan’s provider network. Dr. Barlow’s provider contract with Amity contains a typical most-favored-nation arrangement. The purpose of this arrangement is to

A : Require Dr. Barlow and Amity to use arbitration to resolve any disputes regarding the contract

B :

Specify that the contract is to be governed by the laws of the state in which Amity has its headquarters

C :

Require Dr. Barlow to charge Amity her lowest rate for a medical service she has provided to an Amity plan member, even if the rate is lower than the price negotiated in the contract

D :

State that the contract creates an employment or agency relationship, rather than an independent contractor relationship, between Dr. Barlow and Amity

Answer: C

Question 4

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 5

In health plan pharmacy networks, service costs consist of two components: costs for services associated with dispensing prescription drugs and costs for cognitive services. Cognitive services typically include:

A : making generic substitutions of drugs

B : counseling patients about prescriptions

C : providing patient monitoring

D : switching prescription drugs to preferred drugs

Answer: B

Name:	Network Management (AHM530)
Exam Code:	AHM-530
Certification:	AHIP Certification
Vendor:	AHIP
Total Questions:	205
Last Updated:	Sep 02, 2026

AHIP AHM-530 Answers