Discuss AHIP AHM-530 Exam Topic 6 Question 25

One true statement about the responsibilities of providers under typical provider contracts is that most provider contracts:

Ainclude a clause which states that providers must maintain open communications with patients regarding appropriate treatment plans, unless the services are not covered by the member's health plan

Bhold that the responsibility of the provider to deliver services is usually subject to the provider's receipt of information regarding the eligibility of the member

Ccontain a gag clause or a gag rule

Dinclude a clause that explicitly places the responsibility for medical care on the health plan rather than on the provider of medical services

Suggested Answer: B

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10 comments · newest first

Mee 1 year ago

D is misleading; providers still hold responsibility in many cases.

Tiffiny 1 year ago

B seems more accurate to me, eligibility is key for providers.

Julie 1 year ago

Wait, are you serious? Gag clauses? That's shocking!

Sherell 1 year ago

Totally agree, I've seen that in many agreements.

Martin 1 year ago

A lot of contracts do have gag clauses, it's wild.

Giovanna 1 year ago

This seems straightforward enough. I just need to plug the numbers into the right formula and do the math. As long as I understand the "price waterfall" concept, I should be able to arrive at the correct answer.

Denise 1 year ago

I think I'll go with option B - using business rules. That seems like the most straightforward way to identify and eliminate duplicate cases.

Brendan 1 year ago

Okay, let me see. The question is asking about a form of compensation not based on hours or salary, but on revenue output. That sounds like it could be commission, but I'm also wondering if it could be something like profit-sharing. I'll have to weigh the options carefully.

Isreal 1 year ago

I vaguely recall that the number of domain names you can bind to a bucket is limited. Is it 20? That sounds familiar, but I can't remember exactly.

Nan 1 year ago

This seems like a straightforward security question. I'll focus on the items that have the most impact on the score.

AHIP AHM-530 Exam - Topic 6 Question 25 Discussion