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These are following steps for registering the AHM-520 exam. Step 1: Visit to AHIP Exam Registration Step 2: Signup/Login to AHIP INSURANCE EDUCATION account Step 3: Search for AHM-520 Exam Certifications Exam Step 4: Select Date, time and confirm with payment method

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  • Financial executives working with clients looking to maximize their health dollars
  • Medical management employees working in hospitals, health systems, and, health insurance plans
  • Teachers at the school level who teach health care administration
  • Case administrators and medical directors who inquire a broader administrative background
  • Agents and brokers who expert in life and health insurance
  • Employees who work for health care providers or health insurance plans and want to get the educational background to proceed with a management position in the industry

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Reference: https://www.ahip.org/courses/health-plan-finance-and-risk-management-ahm520

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AHIP AHM-520 Exam Syllabus Topics:

SectionObjectives
Topic 1: Health Plan Financial Fundamentals- Health insurance revenue streams and premium structures
  • 1. Membership and enrollment impact on revenue
    • 2. Premium development basics
      - Cost accounting in health plans
      • 1. Medical cost classification
        • 2. Administrative vs medical expense allocation
          Topic 2: Risk Management in Health Plans- Insurance risk concepts
          • 1. Underwriting principles in managed care
            • 2. Risk pooling and transfer mechanisms
              - Utilization and cost control strategies
              • 1. Provider reimbursement models (capitation, FFS, bundled payments)
                • 2. Managed care cost containment tools
                  Topic 3: Health Plan Payment and Reimbursement Systems- Provider payment methodologies
                  • 1. Capitation and risk adjustment basics
                    • 2. Fee-for-service reimbursement
                      - Value-based payment models
                      • 1. Pay-for-performance programs
                        • 2. Shared savings models

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