AHIP Exam AHM-520 Topic 5 Question 80 Discussion

Actual exam question for AHIP's AHM-520 exam

Question #: 80
Topic #: 5

A health plan that capitates a provider group typically provides or offers to provide stop-loss coverage to that provider group.

ATrue

BFalse

Show Suggested Answer

Suggested Answer: C

by Lucy at Jan 22, 2024, 06:04 AM

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Stephanie

8 days ago

Excellent question! Separating the providers from their hard-earned cash - that's what stop-loss is all about.

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Brinda

9 days ago

True. Gotta love those stop-loss safeguards, am I right? Keeps the providers from going bankrupt.

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Beckie

10 days ago

Hmm, this one's tricky. I'll have to think it through, but my gut says True.

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Viva

12 days ago

I remember learning about this in my healthcare finance class. The correct answer is definitely True.

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Josphine

1 months ago

I'm pretty sure the answer is True. Capitation agreements often include stop-loss coverage to protect the provider group from unexpected high-cost cases.

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Joanna

9 days ago

True

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Marion

16 days ago

Good to know! It helps protect providers from financial risks.

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Annett

23 days ago

That's correct! Capitated health plans often include stop-loss coverage for provider groups.

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Emily

24 days ago

True

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Lamar

1 months ago

True. Even though the provider group is paid per patient, there could still be unexpected high costs that the health plan wants to protect against.

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Charlette

1 months ago

False. Capitation means the provider group is paid a fixed amount per patient, so they would not need stop-loss coverage.

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Ilona

1 months ago

True. The health plan would want to limit their financial risk by offering stop-loss coverage.

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Alysa

2 months ago

Why do you think it's False?

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Christiane

2 months ago

I disagree, I believe the answer is False.

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Alysa

2 months ago

I think the answer is True.

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