AHIP Healthcare Management: An Introduction AHM-250 Question # 139 Topic 3 Discussion

AHIP Healthcare Management: An Introduction AHM-250 Question # 139 Topic 3 Discussion

AHM-250 Exam Topic 3 Question 139 Discussion:
Question #: 139
Topic #: 3

One way that MCOs involve providers in risk sharing is by retaining a percentage of the providers' payment during a plan year. At the end of the plan year, the MCO may use the amount retained to offset or pay for any cost overruns for referral or hospital


A.

withholds


B.

usual, customary, and reasonable (UCR) fees


C.

risk pools


D.

per diems


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