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AHIP AHM-520 Exam Questions

Exam Name: AHIP Health Plan Finance and Risk Management Exam
Exam Code: AHM-520 FAHM
Related Certification(s): AHIP Managed Healthcare Professional Certification
Certification Provider: AHIP
Actual Exam Duration: 90 Minutes
Number of AHM-520 practice questions in our database: 215 (updated: Jun. 16, 2026)
Expected AHM-520 Exam Topics, as suggested by AHIP :
  • Topic 1: Recognize different reserving methodologies used by health insurance providers/ Analyze the role of strategic financial planning in setting a health insurance provider’s future direction
  • Topic 2: Learn about the financial risks for health insurance provider organizations that provide health care services to Medicare and/or Medicaid populations compared to risks within the commercial population
  • Topic 3: Discover how to identify claim related components of health insurance providers’ financial statements
  • Topic 4: Gain an understanding of risk, decisions regarding risk assumption, and how health insurance providers control risk
  • Topic 5: Distinguish between fully funded and self-funded plans and the increasing role of self-funding in the marketplace
  • Topic 6: Compare the difference between stop-loss insurance and stop-loss reinsurance from the perspective of health insurance providers
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Nicolas Rodriguez

10 days ago
AHM 520 felt less about memorizing formulas and more about knowing when to apply them, especially around risk adjustment and pricing basics. I tightened up by working end of chapter problems and I passed on my first attempt.
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Susan Jackson

21 days ago
Premium rate-setting items tested multi-step calculations like applying claim trend, credibility weighting, and profit loads where one misapplied factor ruins the result, practice full walk-throughs of rate builds and memorize the correct order of operations. Focus on trend formulas, credibility concepts, and converting aggregate assumptions to PMPMs so timed problems become manageable.
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Kenneth Clark

2 months ago
Risk adjustment questions focused on HCC interpretation and its effect on capitation payments, often presented as clinical coding scenarios requiring you to choose which diagnoses change the risk score, practice mapping ICD codes to HCC and run several sample PMPM adjustments until the mechanics feel automatic. A colleague passed the AHIP AHM-520 and said Pass4Success’s question collection was perfect for quick, targeted review.
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Emma Moore

2 months ago
The risk adjustment calculation questions on Objective 3 tripped me up because they mixed enrollment changes with diagnosis coding impact. Practicing step-by-step walkthroughs and keeping an eye on denominators really helped when time was tight.
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Heather Ramirez

2 months ago
Also, the way they phrase reinsurance items made it hard to tell whether layers applied per member or per contract, so underline any wording about occurrence.
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Charles Martin

2 months ago
Notably on AHM-520 the actuarial present value problems were sneaky, and treating rounding consistently saved me both time and errors.
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Jason Green

2 months ago
Interesting, I found the scenario-based capitation questions in Objective 4 equally confusing until I drew cash flow timelines on scratch paper.
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Daniel Walker

2 months ago
Honestly I struggled with distinguishing allowed versus disallowed risk-bearing arrangements in Objective 6 until I made a quick checklist of key indicators.
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Edward Wright

1 month ago
Good point about denominators, and for AHIP the financial statement interpretation questions emphasized cash flow impacts more than straight accounting entries.
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Sylvia

3 months ago
Passed the AHIP Finance exam with flying colors! Pass4Success's practice tests were incredibly helpful.
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Edna

3 months ago
Pass4Success's materials were crucial for success! Expect questions on mergers and acquisitions in the health insurance industry.
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Audry

3 months ago
I worried I wouldn't retain complex finance terms, but Pass4Success reinforced key concepts with clear explanations, making me feel prepared—you're closer than you think!
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Edelmira

3 months ago
The exam covers healthcare fraud detection and prevention. Know the financial impact of fraud and common mitigation strategies.
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Youlanda

4 months ago
The cost-sharing and member cost trajectory questions were brutal. Pass4Success helped me rehearse the calculations and memorize the common question patterns.
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Leanna

4 months ago
Aced the AHIP exam, thanks to Pass4Success! Their practice exams mirrored the real thing, so I knew exactly what to expect on test day.
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Gilma

4 months ago
I passed the AHIP Health Plan Finance and Risk Management exam, thanks to Pass4Success. One question that was particularly challenging asked about the various methods of cost containment in health plans. I wasn't entirely sure of my answer, but I still passed.
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Blossom

4 months ago
The tricky topic for me was the underwriting implications of benefit design changes. Pass4Success practice exams exposed the common pitfalls and clarified how changes ripple through the plan finance model.
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Edelmira

5 months ago
I struggled with the risk adjustment methodology, especially reinsurance treatment in the cash flow models. Pass4Success practice questions framed it like real-life cases, and that made the concept stick.
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Sylvia

5 months ago
Feeling overwhelmed by the sheer volume of material? Pass4Success has your back. Their practice questions cover all the key topics so you can revise efficiently.
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Sabina

5 months ago
Nervous about the exam format and case studies, Pass4Success guided me through practice questions and scoring insights, so embrace the process and press forward!
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Roslyn

5 months ago
Happy to announce that I passed the AHIP exam. The Pass4Success practice questions were a great resource. There was a difficult question about the different types of health plan funding arrangements and their financial impact. I wasn't completely confident, but I made it through.
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Matthew

6 months ago
Questions on risk corridors and risk-sharing mechanisms were included. Understand how these programs affect health plan finances.
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Elliott

6 months ago
Struggling with time management during the exam? Try the Pass4Success practice tests - they'll help you get used to the pacing and format so you can stay on track.
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Joanne

6 months ago
Passed thanks to thorough prep! Be prepared to calculate and interpret key financial ratios specific to health insurance companies.
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Mona

6 months ago
Successfully completed the AHIP exam! Huge thanks to Pass4Success for their spot-on practice questions.
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Basilia

7 months ago
I was anxious about the depth of AHIP content, but Pass4Success provided concise reviews and upbeat feedback that built my confidence—keep pushing; you can achieve it!
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Bulah

7 months ago
AHIP certification achieved! Pass4Success's exam questions were a lifesaver for last-minute studying.
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Elin

7 months ago
The toughest part was the actuarial assumptions questions—estimating future claims felt like a moving target, but Pass4Success practice exams helped me drill the scenarios until the numbers clicked.
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Junita

7 months ago
Passing the AHIP Health Plan Finance and Risk Management exam was a game-changer for me. pass4success practice exams were a lifesaver - they really helped me identify my weak areas and focus my studies.
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Matt

8 months ago
My heart pounded at the thought of the risk management scenarios, but pass4success broke them down step by step and offered realistic practice, so stay determined and believe in your prep!
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Cyndy

8 months ago
The exam tests knowledge of investment strategies for health insurers. Review asset allocation principles and regulatory restrictions.
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Lang

8 months ago
I just passed the AHIP Health Plan Finance and Risk Management exam! The Pass4Success practice questions were incredibly useful. One challenging question asked about the key financial ratios used in health plan analysis. I had to think hard about the specifics, but I got through it.
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Junita

8 months ago
I feared running out of time and not understanding tricky finance terms, yet Pass4Success gave me timed drills and focused explanations that made me feel capable—you've got this, future test-takers!
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Tuyet

9 months ago
AHIP certification in the bag! Pass4Success's relevant questions made all the difference in my short prep time.
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Angelica

9 months ago
I was nervous about making mistakes and overthinking every question, but pass4success helped me build a clear study plan and boosted my confidence with structured practice, so go for it and trust your preparation!
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Walker

9 months ago
Passed the AHIP exam, and the Pass4Success practice questions were a big help. There was a tough question about the different types of health plan products and their financial implications. I wasn't entirely sure of my answer, but I still managed to pass.
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Carla

10 months ago
Whew, that AHIP exam was tough! Grateful for Pass4Success's materials - they really helped me prepare quickly.
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Horace

10 months ago
I am excited to share that I passed the AHIP Health Plan Finance and Risk Management exam. The Pass4Success practice questions were essential. One question that I found difficult was about the regulatory requirements for health plans and how they affect financial management. I wasn't sure of the exact details, but I passed.
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Arletta

12 months ago
Expect questions on regulatory compliance costs. Understand the financial implications of major healthcare regulations like ACA and HIPAA.
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Tony

1 year ago
Passed the AHIP Finance exam with flying colors! Pass4Success's materials were a game-changer for quick studying.
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Penney

1 year ago
Pass4Success's practice exams were spot on! Be ready to analyze the impact of demographic changes on health plan finances.
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Arletta

1 year ago
Just became AHIP certified! Pass4Success was crucial for my success. Their exam questions were incredibly helpful.
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Oretha

1 year ago
The exam covers reinsurance in health insurance. Know the types of reinsurance and when they're typically used by health plans.
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Trinidad

1 year ago
Questions on value-based care models appeared. Study different VBC frameworks and their financial implications for health plans.
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Reita

1 year ago
Just passed the AHIP Health Plan Finance exam! Thanks Pass4Success for the spot-on practice questions.
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Xenia

1 year ago
Successfully completed the exam! Be prepared for questions on capitation arrangements. Understand the risks and benefits for both payers and providers.
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Stephanie

1 year ago
The exam tests knowledge of healthcare cost trends. Be familiar with factors driving medical cost inflation and mitigation strategies.
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Jolene

1 year ago
Thanks to Pass4Success, I aced the AHIP exam! Their questions were perfect for last-minute preparation.
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Gussie

1 year ago
Pass4Success really helped with questions on reserve estimation techniques. Understand the methods for calculating IBNR reserves.
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Raul

1 year ago
Just passed the AHIP exam! The Pass4Success practice questions were a great help. One tricky question was about the different types of provider payment methods and their impact on health plan costs. I wasn't completely confident, but I made it through.
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Craig

1 year ago
Expect to interpret financial statements specific to health plans. Practice analyzing balance sheets and income statements for insurers.
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Cassi

1 year ago
AHIP Health Plan Finance exam: check! Pass4Success made it possible with their concise and relevant study materials.
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Cassi

2 years ago
Passed with flying colors! Questions on underwriting practices were prevalent. Know the legal and ethical considerations in health plan underwriting.
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Amira

2 years ago
I passed the AHIP Health Plan Finance and Risk Management exam, thanks to Pass4Success. One question that was particularly difficult asked about the various types of financial risk in health plans and how they are managed. I wasn't entirely sure of my answer, but I still passed.
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Vicente

2 years ago
The exam covers risk-based capital requirements. Study the RBC formula and its implications for health plan financial management.
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Grover

2 years ago
Passed my AHIP certification! Pass4Success provided exactly what I needed to prepare efficiently. Highly recommend!
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Paris

2 years ago
Happy to report that I passed the AHIP exam. The Pass4Success practice questions really helped. There was a challenging question about the different methods of premium rate setting and their implications. I was a bit uncertain, but I managed to pass.
upvoted 0 times
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Hui

2 years ago
Be ready to analyze scenarios related to provider reimbursement models. Understand the pros and cons of different payment structures.
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Royal

2 years ago
I just passed the AHIP Health Plan Finance and Risk Management exam! The Pass4Success practice questions were invaluable. One question that gave me pause was about the principles of underwriting and how they apply to different types of health plans. I wasn't sure about the specifics, but I got through it.
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Aileen

2 years ago
Thanks to Pass4Success, I felt well-prepared for questions on financial solvency regulations. Know the key ratios and regulatory bodies involved.
upvoted 0 times
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Gwen

2 years ago
Wow, that AHIP exam was tough! Grateful for Pass4Success - their questions really matched the actual test.
upvoted 0 times
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Celeste

2 years ago
Passed the AHIP exam, and I couldn't have done it without Pass4Success. There was a particularly tough question on the exam about the various types of health plan reserves and their purposes. I wasn't entirely confident in my answer, but I still managed to pass.
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Carey

2 years ago
The exam tests understanding of actuarial principles in premium setting. Review factors influencing premium rates and pricing strategies.
upvoted 0 times
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Mariko

2 years ago
I am thrilled to share that I passed the AHIP Health Plan Finance and Risk Management exam. The Pass4Success practice questions were spot on. One challenging question asked about the key components of a health plan's financial statement. I had to think hard about the differences between assets and liabilities.
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Lai

2 years ago
Expect calculations involving medical loss ratio (MLR). Study the components and regulatory requirements for MLR reporting.
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Art

2 years ago
AHIP certification achieved! Couldn't have done it without Pass4Success. Their materials were spot-on for quick prep.
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Kirk

2 years ago
Just finished the AHIP exam and passed! The Pass4Success practice questions were a lifesaver. There was a tricky question about the different types of risk management strategies, specifically focusing on the differences between hedging and insurance. I was a bit unsure, but I still managed to pass.
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Raina

2 years ago
Just passed the AHIP Certified: Health Plan Finance and Risk Management exam! Grateful for Pass4Success's relevant practice questions. Be prepared for questions on risk adjustment methodologies in health insurance.
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Glory

2 years ago
I recently passed the AHIP Health Plan Finance and Risk Management exam, and I must say, the Pass4Success practice questions were incredibly helpful. One question that stumped me was about the methods for calculating risk-adjusted return on capital. I wasn't entirely sure which method was most appropriate in a given scenario, but I managed to get through it.
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Stevie

2 years ago
Just passed the AHIP Health Plan Finance exam! Pass4Success was a lifesaver with their relevant practice questions. Thanks!
upvoted 0 times
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Corrina

2 years ago
Passing the AHIP Health Plan Finance and Risk Management exam was a significant achievement for me, and I attribute my success to the practice questions provided by Pass4Success. The exam covered topics such as different reserving methodologies used by health insurance providers and the financial risks for health insurance provider organizations that provide health care services to Medicare and/or Medicaid populations. One question that I recall from the exam was related to the strategic financial planning in setting a health insurance provider's future direction. Despite my uncertainty about the answer, I managed to pass the exam.
upvoted 0 times
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Franchesca

2 years ago
Thrilled to have passed the AHIP exam! A major focus was on actuarial concepts in health insurance. Expect questions on premium rate setting and reserving methods. Brush up on your understanding of medical loss ratios and their calculations. The exam also tested knowledge of value-based care models and their financial impacts. Pass4Success's practice tests were spot-on – they definitely fast-tracked my exam readiness!
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Marva

2 years ago
My experience taking the AHIP Health Plan Finance and Risk Management exam was challenging but rewarding. With the assistance of Pass4Success practice questions, I was able to successfully pass the exam. One question that I remember from the exam was about analyzing the role of strategic financial planning in setting a health insurance provider's future direction. Although I had some doubts about my answer, I was able to overcome them and pass the exam.
upvoted 0 times
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Yuki

2 years ago
Successfully completed the AHIP Risk Management certification! Be prepared for scenarios on identifying and mitigating various types of health plan risks. Understanding reinsurance concepts is crucial. The exam also covered regulatory compliance – know key healthcare laws and their financial implications. Pass4Success's exam questions were invaluable for my quick preparation. So grateful for their help!
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Jannette

2 years ago
Just passed the AHIP Health Plan Finance exam! A key focus was on risk adjustment methodologies. Expect questions on HCC coding and its impact on revenue. Study the different risk adjustment models thoroughly. Thanks to Pass4Success for the spot-on practice questions that helped me prepare efficiently!
upvoted 0 times
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Dianne

2 years ago
I recently passed the AHIP Health Plan Finance and Risk Management exam with the help of Pass4Success practice questions. The exam covered topics such as different reserving methodologies used by health insurance providers and the role of strategic financial planning in setting a health insurance provider's future direction. One question that stood out to me was related to the financial risks for health insurance provider organizations that provide health care services to Medicare and/or Medicaid populations compared to risks within the commercial population. Despite being unsure of the answer, I managed to pass the exam.
upvoted 0 times
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Tish

2 years ago
Just passed the AHIP Health Plan Finance exam! A key topic was risk adjustment models. Expect questions on HCC coding and its impact on revenue. Study the different risk adjustment methodologies. The exam also focused on financial forecasting techniques. Practice interpreting financial statements and projecting future costs. Thanks to Pass4Success for the spot-on practice questions – they really helped me prepare efficiently!
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Free AHIP AHM-520 Exam Actual Questions

Note: Premium Questions for AHM-520 were last updated On Jun. 16, 2026 (see below)

Question #1

The Fairway health plan is a for-profit health plan that issues stock. The following data was taken from Fairway's financial statements:

Current assets.....$5,000,000

Total assets.....6,000,000

Current liabilities.....2,500,000

Total liabilities.....3,600,000

Stockholders' equity.....2,400,000

Fairway's total revenues for the previous financial period were $7,200,000, and its net income for that period was $180,000.

For the previous financial period, Fairway's net profit margin was

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Correct Answer: A

Question #2

The Puma health plan uses return on investment (ROI) and residual income (RI) to measure the performance of its investment centers. Two of these investment centers are identified as X and Y. Investment Center X earns $10,000,000 in operating income on controllable investments of $50,000,000, and it has total revenues of $60,000,000. Investment Center Y earns $2,000,000 in operating income on controllable investments of $8,000,000, and it has total revenues of $10,000,000. Both centers have a minimum required rate of return of 15%.

One difference between the RI method and the ROI method is that

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Correct Answer: A

Question #3

The Column health plan is in the process of developing a strategic plan.

The following statements are about this strategic plan. Three of the statements are true, and one statement is false. Select the answer choice containing the FALSE statement.

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Correct Answer: B

Question #4

A cost for which a benefit is forfeited in choosing one decision alternative over another alternative is known as

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Correct Answer: B

Question #5

Many clinicians are concerned about the development of practice guidelines that seek to define appropriate healthcare services that should be provided to a patient who has been diagnosed with a specific condition. To avoid the risk associated with using such guidelines, health plans should advise clinicians that the existence of such a guideline:

1. Establishes standards of care to be routinely utilized with all patients presenting a specific condition

2. Preempts a physician's judgment when assessing the specific factors related to a patient's condition

Reveal Solution Hide Solution
Correct Answer: D

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