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Reference: https://www.ahip.org/courses/network-management-ahm530
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- Number of Questions: 202
- Length of Examination: 120 minutes
- Format: Multiple choices, multiple answers
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AHIP AHM-530 Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Topic 1: Provider Contracting and Reimbursement | - Contract negotiation and terms - Value-based reimbursement models - Fee-for-service, capitation, and bundled payments |
| Topic 2: Network Performance and Compliance | - Regulatory and accreditation requirements - Network performance metrics |
| Topic 3: Provider Credentialing and Oversight | - Credentialing and re-credentialing processes - Quality monitoring and performance evaluation |
| Topic 4: Utilization and Care Management | - Utilization management tools and techniques - Referral and authorization systems |
| Topic 5: Network Structure and Design | - Network configuration strategies - Network adequacy and geographic coverage requirements - Types of provider networks (HMO, PPO, POS) |
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