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AHIP AHM-520 Exam - Topic 5 Question 80 Discussion

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

AHIP AHM-520 Exam - Topic 5 Question 80 Discussion

Actual exam question for AHIP's AHM-520 exam
Question #: 80
Topic #: 5
[All AHM-520 Questions]

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

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Suggested Answer: C

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

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Mohammad
8 months ago
It’s true, but not all plans do it.
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Elfriede
8 months ago
Really? I’m surprised by that.
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Kenny
9 months ago
Definitely true, I've seen it in action.
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Kip
9 months ago
I thought it was false?
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Emerson
9 months ago
True, that's how it usually works.
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Ines
9 months ago
I’m a bit confused; I thought stop-loss was optional. Could it be false? I need to review that section again.
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Valentin
10 months ago
I feel like I saw a similar question in our practice exams, and it was true. Providers usually need that coverage.
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Reuben
10 months ago
I'm not entirely sure, but I remember something about capitation and risk management. It might be false?
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Candida
10 months ago
I think this is true because stop-loss coverage is meant to protect providers from high costs, especially under capitation.
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Cassie
10 months ago
This seems pretty straightforward to me. If the health plan is capitated, they're taking on more risk, so they would want to offer stop-loss coverage to the provider group to protect themselves. I'll mark True.
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Ronnie
10 months ago
I'm a little confused by the wording here. What exactly is a "capitated provider group"? Is that the same as a capitated health plan? I'll have to guess on this one, but I'm not super confident.
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Breana
10 months ago
Okay, let me break this down. If the health plan is capitated, that means they're paying the provider group a fixed amount per patient. Offering stop-loss coverage seems like a way for the health plan to limit their own financial exposure. I'll go with True on this one.
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Aliza
10 months ago
I'm pretty confident about this one. A capitated provider group typically means the health plan takes on more financial risk, so they would likely offer stop-loss coverage to protect themselves.
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Nickolas
10 months ago
Hmm, I'm not totally sure about this. I'll have to think it through carefully. Does stop-loss coverage mean the provider group takes on more risk, or the health plan?
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Fletcher
10 months ago
I think the key here is to focus on the core elements of a user story, which are the who, what, and why. The technical details in option C don't seem relevant for this question.
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Aja
10 months ago
Hmm, this seems like a tricky one. I'll need to think through the different options carefully.
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Stephanie
1 year ago
Excellent question! Separating the providers from their hard-earned cash - that's what stop-loss is all about.
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Brinda
1 year ago
True. Gotta love those stop-loss safeguards, am I right? Keeps the providers from going bankrupt.
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Beckie
1 year ago
Hmm, this one's tricky. I'll have to think it through, but my gut says True.
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Johnna
1 year ago
I'm not sure, but I'll go with True as well.
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Corinne
1 year ago
I agree, I also think it's True.
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Harrison
1 year ago
I think it's True.
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Viva
1 year ago
I remember learning about this in my healthcare finance class. The correct answer is definitely True.
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Gerald
1 year ago
No, it's actually True.
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Leota
1 year ago
B) False
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Ocie
1 year ago
That's correct!
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Ty
1 year ago
A) True
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Josphine
1 year 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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Brittni
1 year ago
Yes, that's correct. It helps protect the providers from financial risks.
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Viola
1 year ago
I agree, capitated health plans often include stop-loss coverage for provider groups.
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Joanna
1 year ago
True
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Marion
1 year ago
Good to know! It helps protect providers from financial risks.
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Annett
1 year ago
That's correct! Capitated health plans often include stop-loss coverage for provider groups.
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Emily
1 year ago
True
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Lamar
1 year 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 year 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 year ago
True. The health plan would want to limit their financial risk by offering stop-loss coverage.
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Alysa
1 year ago
Why do you think it's False?
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Christiane
1 year ago
I disagree, I believe the answer is False.
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Alysa
1 year ago
I think the answer is True.
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