Achieve Certification with the Best 2024 AHIP Test Answers PDF

What is the Governance and Regulation Exam

The 2024 AHIP Governance and Regulation Exam PDF covers fundamental concepts in healthcare compliance and industry oversight. It assesses candidates' understanding of the regulatory landscape, including HIPAA, ACA, and Medicare Advantage. The exam also explores the roles and responsibilities of key stakeholders, such as insurance commissioners, regulators, and healthcare providers. By studying this outline, individuals can gain a comprehensive overview of the governance and regulatory framework that governs the healthcare industry.

How Many Questions Are on the 2025 AHIP?

The 2024 AHIP exam consists of 125 multiple-choice questions. Candidates have 3 hours and 30 minutes to complete the exam, which covers a wide range of topics related to health insurance. These include:

• Health insurance fundamentals
• Medical terminology and anatomy
• Health insurance benefits and coverage
• Health insurance underwriting and rating
• Health insurance claims and payment
• Health insurance regulations
• Ethics and professionalism

Candidates who are well-prepared and have a strong understanding of these topics will be more likely to achieve a passing score on the exam.

How Hard is the AHIP Test in 2025?

The difficulty of the AHIP exam varies depending on the individual's knowledge and experience in the health insurance industry. However, many candidates find the exam to be challenging, as it covers a wide range of topics and requires a deep understanding of health insurance concepts and regulations. To increase your chances of success, it is important to prepare thoroughly for the exam. This includes studying the official AHIP study materials, taking practice exams, and attending a prep course if possible. Additionally, it is helpful to have some prior experience working in the health insurance industry, as this will give you a solid foundation of knowledge to build on.

Overall, the AHIP exam is a challenging but achievable exam for those who are well-prepared. By dedicating yourself to studying and preparing, you can increase your chances of passing the exam and obtaining your AHIP certification.

What is the Passing Score for AHIP?

The passing score for the AHIP exam is 70%. This means that candidates must answer at least 70% of the questions correctly to pass the exam. The AHIP exam is challenging, and many candidates find it helpful to prepare thoroughly by studying the official AHIP study materials, taking practice exams, and attending a prep course if possible. Additionally, it is helpful to have some prior experience working in the health insurance industry, as this will give you a solid foundation of knowledge to build on. If you do not pass the AHIP exam on your first attempt, do not be discouraged. Many candidates need to take the exam multiple times before they pass. The important thing is to learn from your mistakes and continue to prepare until you are successful.

How Much Does it Cost To Take the AHIP Exam in 2025?

The cost to take the AHIP exam in 202 5 is $245. This fee includes the cost of the exam itself, as well as the cost of the AHIP study materials. The study materials include a study guide, practice exams, and access to online resources. Candidates who are members of the National Association of Health Underwriters (NAHU) are eligible for a discounted exam fee of $195. To qualify for the discount, candidates must be current members of NAHU and provide their NAHU member ID number when registering for the exam. Candidates who do not pass the AHIP exam on their first attempt can retake the exam for a fee of $125. The retake fee includes the cost of the exam itself but does not include the cost of the study materials.

AHIP FINAL EXAM TEST QUESTIONS AND ANSWERS (2024/2025) (VERIFIED ANSWERS)( ALL BUNDLED HERE!!)

The 2024 AHIP Test Answers PDF is a valuable resource for candidates preparing for the AHIP exam. This document contains all of the questions and answers from the 2024 AHIP exam, and it is a great way to practice for the actual exam. The 2024 AHIP Test Answers PDF is available for purchase from a variety of sources, including the AHIP website and Amazon.com. The cost of the PDF varies depending on the source, but it is typically around $50-$75. Once you have purchased the 2024 AHIP Test Answers PDF, you can begin studying for the exam. The PDF is organized by topic, so you can easily focus on the areas that you need to improve. The questions and answers are also explained in detail, so you can understand why each answer is correct. By studying the 2024 AHIP Test Answers PDF, you can increase your chances of passing the AHIP exam on your first attempt. This document is a valuable resource for all candidates who are serious about passing the exam.

What's In the AHIP Certification?

The AHIP certification is a professional designation for individuals who work in the health insurance industry. The certification demonstrates that the individual has a comprehensive understanding of health insurance products and services, as well as the regulatory environment in which the industry operates. To obtain the AHIP certification, individuals must pass a rigorous exam that covers a wide range of topics, including:

• Health insurance fundamentals
• Medical terminology and anatomy
• Health insurance benefits and coverage
• Health insurance underwriting and rating
• Health insurance claims and payment
• Health insurance regulations
• Ethics and professionalism

Individuals who pass the AHIP exam and maintain their certification are required to complete continuing education credits every two years to stay up-to-date on the latest industry trends and developments. The AHIP certification is a valuable credential for individuals who work in the health insurance industry. It demonstrates that the individual has the knowledge and skills necessary to provide quality customer service and advice to clients.

What You'll Learn with DumpsArena 2024 AHIP Test Answers PDF

If you're preparing for the AHIP (America's Health Insurance Plans) Certification Exam, DumpsArena offers an excellent resource with their 2024 AHIP Test Answers PDF. Here's what you can expect to learn and gain by using this study material:

1. Comprehensive Coverage of AHIP Exam Topics

The PDF includes well-researched content covering all key areas of the AHIP syllabus, such as:

• Fundamentals of health insurance and managed care.
• Medicare, Medicaid, and the Affordable Care Act (ACA).
• Key regulations and compliance requirements.
• Health insurance fraud, waste, and abuse prevention strategies.

2. Accurate and Updated Questions and Answers

DumpsArena ensures its content is up-to-date with the latest exam trends and policies. You'll get:

• Real exam-like questions.
• Verified answers with explanations for better understanding.

3. Enhanced Exam Readiness

By practicing with DumpsArena's AHIP materials, you will:

• Familiarize yourself with the exam structure and question formats.
• Build confidence to tackle complex scenarios.
• Improve your time management skills during the actual exam.

4. Ease of Use and Accessibility

The PDF format is easy to download and access anytime, anywhere, making it perfect for busy professionals. You can:

• Study on-the-go using your laptop, tablet, or smartphone.
• Print the materials for offline preparation.

5. Boosted Chances of Passing on the First Attempt

With detailed answers and explanations, DumpsArena equips you to:

• Identify knowledge gaps.
• Master difficult topics.
• Achieve a high score with minimal study time.

FAQs

What is the AHIP exam?

The AHIP exam is a certification exam for individuals who work in the health insurance industry. The exam covers a wide range of topics, including health insurance fundamentals, medical terminology, and health insurance regulations.

Who should take the AHIP exam?

The AHIP exam is ideal for individuals who work in the health insurance industry and want to demonstrate their knowledge and skills. The exam is also beneficial for individuals who are new to the industry and want to gain a comprehensive understanding of health insurance.

What are the benefits of passing the AHIP exam?

Passing the AHIP exam demonstrates that the individual has the knowledge and skills necessary to provide quality customer service and advice to clients. The certification is also a valuable credential for individuals who are looking to advance their careers in the health insurance industry.

How do I prepare for the AHIP exam?

There are a variety of resources available to help individuals prepare for the AHIP exam, including study guides, practice exams, and online courses. The AHIP website also provides several resources, including a study guide and practice questions.

How much does it cost to take the AHIP exam?

The cost of the AHIP exam is $245. The fee includes the cost of the exam itself, as well as the cost of the study materials.

Where can I take the AHIP exam?

The AHIP exam is offered at testing centers throughout the United States. Candidates can register for the exam online or by calling the AHIP customer service number.

Governance and Regulation

AHIP AHM-510

Version Demo

Total Demo Questions: 10

Total Premium Questions: 76

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QUESTION NO: 1

The Opal Health Plan complies with all of the provisions of the Newborns' and Mothers' Health Protection Act of 1996 (NMHPA). Samantha Hill and Debra Chao are Opal enrollees. Ms. Hill was hospitalized for a cesarean birth, and Ms. Chao was hospitalized for a normal delivery. From the following answer choices, select the response that indicates the minimum hospital stay for which Opal, under NMHPA, must provide benefits for Ms. Hill and Ms. Chao.

A. Ms. Hill: 72 hours; Ms. Chao: 24 hours

B. Ms. Hill: 72 hours; Ms. Chao: 48 hours

C. Ms. Hill: 96 hours; Ms. Chao: 24 hours

D. Ms. Hill: 96 hours; Ms. Chao: 48 hours

QUESTION NO: 2

The government uses various tools within the realm of two broad categories of public policy-allocative policies and regulatory

policies. In the context of public policy, laws that fall into the category of allocative policy include

A. The Balanced Budget Act (BBA) of 1997

B. The Health Insurance Portability and Accountability Act (HIPAA) of 1996

C. Laws affecting health plan quality oversight

D. Laws specifying procedures for health plan handling of consumer appeals and grievances

QUESTION NO: 3

In the paragraph below, a statement contains two pairs of terms enclosed in parentheses. Determine which term in each pair correctly completes the statement. Then select the answer choice containing the two terms that you have chosen. Inflation plays a role in the health plan environment by influencing the prices of healthcare services, supplies, and coverage. During an inflationary period, consumers typically have (more / less) purchasing power because the prices of goods and services increase (more / less) quickly than income.

A. More / more

B. More / less

C. Less / more

D. Less / less

QUESTION NO: 4

In the paragraph below, a statement contains two pairs of terms enclosed in parentheses. Determine which term in each pair correctly completes the statement. Then select the answer choice containing the two terms that you have chosen. In the case of Pacific are of Oklahoma, Inc. v. Burrage, the U.S. Court of Appeals for the Tenth Circuit considered whether ERISA preempts medical malpractice claims against health plans based on certain liability theories. In this case, the Tenth Circuit court held that ERISA (should / should not) preempt a liability claim against an HMO for the malpractice of one of its primary care physicians, and therefore the HMO was subject to a claim of (subordinated / vicarious) liability.

A. Should / subordinated

B. Should / vicarious

C. Should not / subordinated

D. Should not / vicarious

QUESTION NO: 5

TRICARE, a military healthcare program, offers eligible beneficiaries three options for healthcare services: TRICARE Prime, TRICARE Extra, and TRICARE Standard. With respect to plan features, both an annual deductible and claims filing requirements must be met, regardless of whether care is delivered by network providers, under

A. TRICARE Prime and TRICARE Extra only

B. TRICARE Extra and TRICARE Standard only

C. TRICARE Standard only

D. None of these healthcare options

QUESTION NO: 6

The Department of Health and Human Services (HHS) has delegated its responsibility for the development and oversight of regulations under the Health Insurance Portability and Accountability Act (HIPAA) to an office within the Centers for Medicaid & Medicare Services (CMS). The CMS office that is responsible for enforcing the federal requirements of HIPAA is the

A. Center for Health Plans and Providers (CHPPs)

B. Center for Medicaid and State Operations

C. Center for Beneficiary Services

D. Center for Managed Care

QUESTION NO: 7

From the following answer choices, choose the term that best corresponds to this description. The SureQual Group is a group of practicing physicians and other healthcare professionals paid by the federal government to review services ordered or furnished by other practitioners in the same medical fields for the purpose of determining whether medical services provided were reasonable and necessary, and to monitor the quality of care given to Medicare patients.

A. Health insuring organization (HIO)

B. Independent Practice Association (IPA)

C. Physician practice management (PPM) company

D. Peer review organization (PRO)

QUESTION NO: 8

The following situations illustrate per se violations of federal antitrust laws: Situation A - Two groups of providers agreed among themselves that each provider will do business with health plans only on a fee-for-service basis. Situation B - To avoid competing with each other, two independent, competing physician-hospital organizations (PHOs) divide the geographic areas in which they will market their services. From the following answer choices, select the response that correctly identifies the types of per se violations illustrated by these situations.

A. Situation A: price fixing; Situation B: horizontal division of markets

B. Situation A: price fixing; Situation B: tying arrangement

C. Situation A: horizontal group boycott; Situation B: horizontal division of markets

D. Situation A: horizontal group boycott; Situation B: tying arrangement

QUESTION NO: 9

Antitrust laws can affect the formation, merger activities, or acquisition initiatives of a health plan. In the United States, the two federal agencies that have the primary responsibility for enforcing antitrust laws are the

A. Internal Revenue Service (IRS) and the Department of Justice (DOJ)

B. Office of Inspector General (OIG) and the Department of Defense (DOD)

C. Federal Trade Commission (FTC) and the Department of Labor (DOL)

D. Federal Trade Commission (FTC) and the Department of Justice (DOJ)

QUESTION NO: 10

The Sawgrass Health Center is an institution that trains healthcare professionals and performs various clinical and other types of healthcare-related research. Because Sawgrass receives government funding, it is required to provide medical care for the poor. Of the following types of health plans, Sawgrass can best be described as:

A. A medical foundation

B. An academic medical center (AMC)

C. A healthcare cooperative

D. A community health center (CHC)