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AHIP AHM-530 Exam - Topic 2 Question 24 Discussion

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:
D) An exculpation clause.
A) A business confidentiality clause.
B) A scope of services clause.
C) An informed refusal clause.

AHIP AHM-530 Exam - Topic 2 Question 24 Discussion

Actual exam question for AHIP's AHM-530 exam
Question #: 24
Topic #: 2
[All AHM-530 Questions]

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:

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Suggested Answer: D

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

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Nieves
9 months ago
I think it’s a scope of services clause, actually.
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Vi
9 months ago
Definitely a business confidentiality clause!
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Tawna
10 months ago
Wait, so they can deny payment but not give a medical opinion? That's weird.
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Sherita
10 months ago
I disagree, it seems more like an informed refusal clause.
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Lasandra
10 months ago
Sounds like an exculpation clause to me.
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Erasmo
10 months 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.
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Lettie
10 months ago
I remember calculating the weighted average contribution last week, but I'm unsure about the exact formula to use here.
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Maybelle
10 months 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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