Free AHM-250: Healthcare Management: An Introduction Exam Questions and Answers

Last updated: September 11, 2026

Exam code

AHM-250

Provider

AHIP

Questions in our bank

1000+

Free to read

First 10, with answers

Official page

Official Exam website

Our test mode duration & pass mark

130 mins · 70%

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1. Question #1

   - (Topic 1) From the following choices, choose the definition that best matches the term health risk assessment (HRA)

   • A. A technique used to determine if a health condition is present even if a member has not experienced symptoms of the problem
   • B. A technique used to educate plan members on how to distinguish between minor problems and serious conditions and effectively treat minor problems
   • C. A technique used to evaluate the medical necessity, appropriateness, and cost- effectiveness of healthcare services for a given patient
   • D. A technique in which information about a plan member's health status, personal and family health history, and health-related behaviors is used to predict the
   Reveal Answer

2. Question #2

   - (Topic 1) In 1999, the United States Congress passed the Financial Services Modernization Act, referred to as the Gramm-Leach-Bliley (GLB) Act. The primary provisions included under the GLB Act require financial institutions, including health plans, to take several

   • A. Disclose to affiliates, but not to third parties, their privacy policies regarding the sharing of nonpublic personal financial information.
   • B. Notify customers of any sharing of non-public personal financial information with nonaffiliated third parties.
   • C. Prohibit customers from having the opportunity to 'opt-out' of sharing non-public personal financial information.
   • D. Agree not to disclose personally identifiable financial information or personally identifiable health information.
   Reveal Answer

3. Question #3

   - (Topic 1) From the following choices, choose the definition that best matches the term Screening

   • A. A technique used to educate plan members on how to distinguish between minor problems and serious conditions and effectively treat minor problems
   • B. A technique used to determine if a health condition is present even if a member has not experienced symptoms of the problem
   • C. A technique used to evaluate the medical necessity, appropriateness, and cost- effectiveness of healthcare services for a given patient
   • D. A technique in which information about a plan member's health status, personal and family health history, and health-related behaviors is used to predict the
   Reveal Answer

4. Question #4

   - (Topic 1) In order to measure the expenses of institutional utilization, Holt Healthcare Group uses the standard formula to calculate hospital bed days per 1,000 plan members per year. On October 23, Holt used the following information to calculate the bed days per

   • A. 403
   • B. 920
   • C. 397
   • D. 278
   Reveal Answer

5. Question #5

   - (Topic 1) An exclusive provider organization (EPO) operates much like a PPO. However, one difference between an EPO and a PPO is that an EPO

   • A. Is not subject to state insurance laws
   • B. Has no provider network of physicians
   • C. Generally provides no benefits for out-of-network care
   • D. Is regulated under federal HMO legislation
   Reveal Answer

6. Question #6

   - (Topic 1) Although the process is voluntary for health plans, external accreditation is becoming more and more important as states and purchasers require health plans undergo as many states and purchasers require health plans undergo some type of external review pr

   • A. Requires all change accreditation organizations to use the same standards of accreditation.
   • B. Cannot assure that a health plan meets a specified level of quality.
   • C. Is voluntary for health plans.
   • D. Typically requires the accrediting organization to conduct a medical record review and a review of a health plan's credentialing processes, but not an evaluation
   Reveal Answer

7. Question #7

   - (Topic 2) The Citywide Health Group is a large provider-based health plan that includes physician groups, hospitals, and other facilities. In order to oversee and manage the operation of the organization, Citywide has established an enterprise scheduling system. The

   • A. allow Citywide's different components to function as a single organization in arranging access to facilities and resources
   • B. provide information to Citywide's management regarding provider licensure, certification, and malpractice history
   • C. facilitate the processing of requests for authorization of payment of benefits
   • D. detect instances of overutilization, underutilization, or inappropriate utilization of medical resources
   Reveal Answer

8. Question #8

   - (Topic 2) One characteristic of disease management programs is that they typically

   • A. use clinical practice processes to standardize the implementation of best practices among providers
   • B. focus on managing populations of patients who have a specific chronic illness or medical condition, but do not focus on patient populations who are at risk of
   • C. are used to coordinate the care of members with any type of disease, either chronic or nonchronic
   • D. focus on individual episodes of medical care rather than on the comprehensive care of the patient over time
   Reveal Answer

9. Question #9

   - (Topic 2) Khalyn Drury's employer includes managed dental care in its employee benefits package. During open enrollment, Ms. Drury enrolled in the dental plan, which provides dental services to its members in exchange for a prepayment (the premium). Dental services

   • A. traditional fee-for-service (FFS) dental plan
   • B. dental health maintenance organization (DHMO)
   • C. dental preferred provider organization (PPO)
   • D. plan with a dental point of service (POS) option
   Reveal Answer

10. Question #10

    - (Topic 2) One feature of the Employee Retirement Income Security Act (ERISA) is that it:

    • A. Requires that state insurance laws apply to all employee benefit plans except insured plans.
    • B. Contains a pre-emption provision, which typically makes the terms of ERISA take precedence over any state laws that regulate employee welfare benefit plans.
    • C. Requires self-funded employee benefit plans to pay premium taxes at the state level.
    • D. Contains strict reporting and disclosure requirements for all employee benefit plans except health plans.
    Reveal Answer