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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

Question 1

The Jamal Health Plan operates in a state that mandates that a health plan either allow providers to become part of its network or reimburse those providers at the health plan’s negotiated-contract rate, so long as the non-contract provider is willing to perform the services at the contract rate. This type of law is known as:

Options:

A.

A fair procedure law

B.

A direct access law

C.

An any willing provider law

D.

A due process law

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Question 2

Kevin Olin applied for individual healthcare coverage from the Mercury health plan. Before issuing the policy, Mercury's underwriters attached a rider that excludes from coverage any loss that results from Mr. Olin's chronic knee problem. This information indicates that Mr. Olin's policy includes

Options:

A.

a moral hazard rider

B.

an essential plan rider

C.

an impairment rider

D.

an insurable interest rider

Question 3

The Coral Health Plan, a for-profit health plan, has two sources of capital:

Debt and equity. With regard to these sources of capital, it can correctly be stated that

Options:

A.

Coral's equity holders have an ownership interest in the health plan

B.

The interest that Coral pays on its debt most likely is not tax deductible to Coral

C.

Coral's debt holders have no legal claim to Coral's assets

D.

Equity is a more risky source of capital, from Coral's perspective, than is debt