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AHIP AHM-530 Exam - Topic 2 Question 24 Discussion

Posted by Blair on May 09, 2022 at 08:14 AM

The provider contracts that the Indigo Health Plan has with its providers include a clause which states that Indigo's denial of payment for a certain medical procedure does not constitute a medical opinion and is not intended to interfere with the provider-patient relationship. This information indicates that Indigo's provider contracts include:

Suggested Answer: D

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8 comments · newest first
NI
Nieves 1 year ago
I think it’s a scope of services clause, actually.
VI
Vi 1 year ago
Definitely a business confidentiality clause!
TA
Tawna 1 year ago
Wait, so they can deny payment but not give a medical opinion? That's weird.
SH
Sherita 1 year ago
I disagree, it seems more like an informed refusal clause.
LA
Lasandra 1 year ago
Sounds like an exculpation clause to me.
ER
Erasmo 1 year ago
I'm a bit confused on how the Cobweb model works, but I think the key is looking at the relative elasticities of demand and supply. I'll have to review my notes.
LE
Lettie 1 year ago
I remember calculating the weighted average contribution last week, but I'm unsure about the exact formula to use here.
MA
Maybelle 1 year ago
Hmm, I'm a bit unsure about this one. I know OVM has a master-slave architecture, but I can't quite recall how it handles a master server failure. I'll have to think this through step-by-step.
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