AHIP AHM-530 Exam - Topic 5 Question 18 Discussion

Actual exam question for AHIP's AHM-530 exam

Question #: 18
Topic #: 5

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:

A$200

B$1,000

C$1,800

D$9,000

Show Suggested Answer

Suggested Answer: C

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

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Glory

5 months ago

Are you sure about that? Seems like the insurer should cover more.

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Stevie

5 months ago

Definitely $1,000. Just subtract the attachment point and apply the coinsurance.

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Tamar

5 months ago

Wait, how does the coinsurance work here? I'm confused.

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Pamela

5 months ago

I think it's $1,800, right? That sounds about right.

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Kris

5 months ago

The insurer covers costs above $8,000, so they pay on the excess.

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Tonette

6 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

6 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

6 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

6 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

6 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

6 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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