All AHM-520 Test Inside AHIP Questions

With regard to a health plan's underwriting of groups, it can correctly be stated that, generally, a

In order to calculate a simple monthly capitation payment, the Argyle Health Plan used the following information:

• The average number of office visits each member makes in a year is two
• The FFS rate per office visit is $55
• The member copayment is $5 per office visit
• The reimbursement period is one month

Given this information, Argyle would correctly calculate that the per member per month (PMPM) capitation rate should be

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.

Users of the Fulcrum Health Plan financial information include:

• The independent auditors who review Fulcrum's financial statements
• Fulcrum's controller (comptroller)
• Fulcrum's plan members
• The providers that deliver healthcare services to Fulcrum plan members
• Fulcrum's competitors

Of these users, the ones that most likely can correctly be classified as external users with a direct financial interest in Fulcrum are the