AHIP Exam AHM-520 Topic 1 Question 82 Discussion

Actual exam question for AHIP's AHM-520 exam

Question #: 82
Topic #: 1

A health plan may experience negative working capital whenever healthcare expenses generated by plan members exceed the premium income the health plan receives.

Ways in which a health plan can manage the volatility in claims payments, and therefore reduce the risk of negative working capital, include:

1. Accurately estimating incurred but not reported (IBNR) claims

2. Using capitation contracts for provider reimbursement

ABoth 1 and 2

B1 only

C2 only

DNeither 1 nor 2

Show Suggested Answer

Suggested Answer: A

by Lorean at Mar 10, 2024, 09:57 AM

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Isreal

6 months ago

So, the answer would be both Lillian and Telma, right?

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Venita

6 months ago

Another way is using capitation contracts for provider reimbursement. That's option Telma.

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Delbert

6 months ago

One way is accurately estimating incurred but not reported claims. That's option Lillian.

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Xuan

6 months ago

So, what are the ways a health plan can manage this risk?

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Telma

7 months ago

I agree. If expenses exceed income, it can lead to negative working capital.

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Lillian

7 months ago

I think managing the volatility in claims payments is crucial for a health plan.

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Mireya

7 months ago

I'm not too sure about that. I think the answer might be C) 2 only.

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Una

7 months ago

I agree with Coral. Managing incurred but not reported claims and using capitation contracts can help reduce risk.

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Coral

8 months ago

I think the answer is A) Both 1 and 2.

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