AHIP AHM-530 Exam - Topic 6 Question 105 Discussion

Actual exam question for AHIP's AHM-530 exam

Question #: 105
Topic #: 6

The following statements are about the organization of network management functions of health plans. Select the answer choice containing the correct response:

ACompared to a large health plan, a small health plan typically has more integration among its network management activities and less specialization of roles.

BIt is usually more efficient to have a large health plan's provider relations representatives located in the health plan's corporate headquarters rather than based in regional locations that are close to the provider offices the representatives cover.

CAn health plan's provider relations representatives are usually responsible for conducting an initial orientation of providers and educating providers about health plan developments, rather than recruiting and assisting with the selection of new providers.

DIn general, a health plan that uses a centralized approach for some of its network management activities should not use a decentralized approach for other network management activities.

Show Suggested Answer

Suggested Answer: A

by Iluminada at Jan 12, 2025, 10:59 AM

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Isidra

3 months ago

D seems too rigid, some decentralization can be beneficial!

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Jutta

3 months ago

C sounds off, isn't recruiting a big part of their job?

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Isreal

4 months ago

Wow, I never thought about provider reps being based at HQ.

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Marilynn

4 months ago

I disagree, larger plans can integrate well too!

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Alba

4 months ago

A small health plan really does have more integration, it's true.

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Shawn

4 months ago

I think D sounds a bit off; it seems like a health plan could use both centralized and decentralized approaches for different activities, right?

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Denae

4 months ago

I practiced a question similar to C, and it mentioned that provider relations reps do more than just orientation, so I’m leaning towards that being incorrect.

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Brande

5 months ago

I'm not entirely sure, but I feel like having provider relations reps close to the providers makes more sense, which makes me question B.

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Natalie

5 months ago

I remember discussing how smaller health plans often have more integrated roles, so I think A might be correct.

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Nickie

5 months ago

This is a tricky one. I'm a bit confused about the nuances between the answer choices. I'll need to re-read the question and options a few times to make sure I grasp the key distinctions before selecting an answer.

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Robt

5 months ago

Okay, let me see. The question is asking about the organization of network management functions, so I need to focus on how small vs. large health plans handle those activities. I'll try to visualize the differences and match that to the answer choices.

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Shanice

5 months ago

Hmm, I'm not totally sure about this one. The options seem to be comparing different aspects of network management, but I'm not confident I fully understand the differences. I'll have to think it through step-by-step.

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Brandee

5 months ago

This question seems straightforward, I think I can handle it. I'll read through the options carefully and try to identify the key differences between small and large health plans.

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Jacquelyne

10 months ago

E) The health plan's network management team should be like a well-oiled machine - with lots of gears and cogs working together seamlessly. Or maybe just a tangled web of confusion, who knows?

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Mitzie

8 months ago

B) It is usually more efficient to have a large health plan's provider relations representatives located in the health plan's corporate headquarters rather than based in regional locations that are close to the provider offices the representatives cover.

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Tina

8 months ago

E) The health plan's network management team should be like a well-oiled machine - with lots of gears and cogs working together seamlessly. Or maybe just a tangled web of confusion, who knows?

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Carolynn

8 months ago

A) Compared to a large health plan, a small health plan typically has more integration among its network management activities and less specialization of roles.

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Avery

10 months ago

D) That's a bit rigid. Health plans should use the approach that works best for each activity.

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Kayleigh

10 months ago

C) I agree, the provider reps' main job is educating providers, not just recruiting them.

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Joana

9 months ago

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Lashunda

9 months ago

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Tequila

9 months ago

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Ruthann

10 months ago

B) Placing provider reps at HQ seems inefficient. They should be close to the providers they work with.

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Rosalyn

9 months ago

C) An health plan's provider relations representatives are usually responsible for conducting an initial orientation of providers and educating providers about health plan developments, rather than recruiting and assisting with the selection of new providers.

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Coral

9 months ago

B) Placing provider reps at HQ seems inefficient. They should be close to the providers they work with.

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Graham

10 months ago

A) Compared to a large health plan, a small health plan typically has more integration among its network management activities and less specialization of roles.

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