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AHIP AHM-530 Exam - Topic 5 Question 18 Discussion

A provider group purchased from an insurer individual stop-loss coverage for primary and specialty care services with an $8,000 attachment point and 10% coinsurance. If the group's accrued cost for the primary and specialty care treatment of one patient is $10,000, then the amount that the insurer would be responsible for reimbursing the provider group for these costs is:
C) $1,800
A) $200
B) $1,000
D) $9,000

AHIP AHM-530 Exam - Topic 5 Question 18 Discussion

Actual exam question for AHIP's AHM-530 exam
Question #: 18
Topic #: 5
[All AHM-530 Questions]

A provider group purchased from an insurer individual stop-loss coverage for primary and specialty care services with an $8,000 attachment point and 10% coinsurance. If the group's accrued cost for the primary and specialty care treatment of one patient is $10,000, then the amount that the insurer would be responsible for reimbursing the provider group for these costs is:

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Suggested Answer: C

by Allene at May 07, 2022, 09:32 AM

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Glory
9 months ago
Are you sure about that? Seems like the insurer should cover more.
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Stevie
9 months ago
Definitely $1,000. Just subtract the attachment point and apply the coinsurance.
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Tamar
10 months ago
Wait, how does the coinsurance work here? I'm confused.
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Pamela
10 months ago
I think it's $1,800, right? That sounds about right.
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Kris
10 months ago
The insurer covers costs above $8,000, so they pay on the excess.
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Tonette
10 months ago
Okay, let me read through the options and see if I can spot any obvious issues. Metadata mirroring, dynamic subtree organization, object-wise storage - these all sound like plausible features, so I'll need to dig deeper.
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Aja
10 months ago
I practiced a similar question before, and I believe the answer should be around $83,000, but I can't recall the exact calculation.
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Rolf
10 months ago
Hmm, I'm a bit confused on this one. I know consumption assets are things that are used for personal use, but I'm not sure if land, buildings, or heavy equipment would count. I'll have to think this through carefully.
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Mona
10 months ago
A bar chart could work well to compare the customer visit data across the different store locations. That would let us see how the visits vary based on the population in each area.
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Patrick
10 months ago
I'm a little confused by the wording of the question. Does the recitals section only include those three specific statements, or can it include other types of information as well? I want to make sure I'm not missing something.
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Johnna
10 months ago
I feel pretty confident about this one. The rapid growth of social networking sites is definitely a major factor that has driven increased privacy regulations.
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