AHIP AHM-530 Exam - Topic 1 Question 23 Discussion
The provider contract that Dr. Bijay Patel has with the Arbor Health Plan includes a no-balancebilling clause. The purpose of this clause is to:
D) require Dr. Patel to accept Arbor's payment as payment in full for medical services that he provides to Arbor plan members
A) prohibit Dr. Patel from collecting payments from Arbor plan members for medical services that he provided them, even if the services are explicitly excluded from the benefit plan
B) allow Dr. Patel to bill patients for services only if the services are considered to be medically necessary
C) establish the guidelines used to determine if Arbor is the primary payor of benefits in a situation in which an Arbor plan member is covered by more than one health plan
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