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AHM-520 Exam Dumps : Health Plan Finance and Risk Management

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Health Plan Finance and Risk Management Questions and Answers

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Question 1

The physicians who work for the Sunrise Health Plan, a staff model HMO, are paid a salary that is not augmented with another type of incentive plan. Compared to the use of a traditional reimbursement method, Sunrise's use of a salary reimbursement method is more likely to

Options:

A.

Encourage Sunrise's physicians to perform services that are not medically necessary

B.

Completely eliminate service risk for Sunrise's physicians

C.

Decrease Sunrise's liability for any negligent acts of the physicians in the plan's network of providers

D.

Help stabilize expenses for Sunrise

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Question 2

The following information relates to the Hardcastle Health Plan for the month of June:

  • Incurred claims (paid and IBNR) equal $100,000
  • Earned premiums equal $120,000
  • Paid claims, excluding IBNR, equal $80,000
  • Total health plan expenses equal $300,000

This information indicates that Hardcastle’s medical loss ratio (MLR) for the month of June was approximately equal to:

Options:

A.

40%

B.

67%

C.

83%

D.

120%

Question 3

One true statement about cash-basis accounting is that

Options:

A.

Cash receipt, but not cash disbursement, is an important component of cash-basis accounting

B.

Most companies use a pure cash-basis accounting system

C.

Cash-basis accounting records revenue according to the realization principle and expenses according to the matching principle

D.

Health insurance companies and health plans that fall under the jurisdiction of state insurance commissioners must report some items on a cash basis for statutory reporting purposes

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