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AHIP AHM-530 Exam - Topic 4 Question 27 Discussion

The provider contract that Dr. Nick Mancini has with the Utopia Health Plan includes a clause that requires Utopia to reimburse Dr. Mancini on a fee-for-service (FFS) basis until 100 Utopia members have selected him as their primary care provider (PCP). At that time, Utopia will begin reimbursing him under a capitated arrangement. This clause in Dr. Mancini's provider contract is known as:
B) a low-enrollment guarantee clause
A) an antidisparagement clause
C) a retroactive enrollment changes clause
D) an eligibility guarantee clause

AHIP AHM-530 Exam - Topic 4 Question 27 Discussion

Actual exam question for AHIP's AHM-530 exam
Question #: 27
Topic #: 4
[All AHM-530 Questions]

The provider contract that Dr. Nick Mancini has with the Utopia Health Plan includes a clause that requires Utopia to reimburse Dr. Mancini on a fee-for-service (FFS) basis until 100 Utopia members have selected him as their primary care provider (PCP). At that time, Utopia will begin reimbursing him under a capitated arrangement. This clause in Dr. Mancini's provider contract is known as:

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Suggested Answer: B

by Kaitlyn at May 09, 2022, 04:16 PM

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Benton
8 months ago
Eligibility guarantee clause? Nah, that's not it.
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Lucy
8 months ago
Wait, is this really how contracts work? Seems odd.
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Benedict
8 months ago
Agree, it sounds like a low-enrollment guarantee to me.
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Jessenia
8 months ago
I thought it was a retroactive enrollment changes clause?
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Miesha
8 months ago
That's definitely a low-enrollment guarantee clause!
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Huey
9 months ago
I remember learning about this in class, but I can't recall the exact company. I'll have to make an educated guess.
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Valentine
9 months ago
Hmm, this looks like a tricky XSLT question. I'll need to carefully read through the XML document and the expected output to figure out the right approach.
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Herminia
9 months ago
I've seen questions like this before, I think I know the right approach to solve it.
upvoted 0 times
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Van
9 months ago
This seems like a tricky one. I'll need to think through the security constraints carefully.
upvoted 0 times
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