AHIP Health Plan Finance and Risk Management AHM-520 Question # 75 Topic 2 Discussion

AHIP Health Plan Finance and Risk Management AHM-520 Question # 75 Topic 2 Discussion

AHM-520 Exam Topic 2 Question 75 Discussion:
Question #: 75
Topic #: 2

The provider contract that Dr. Zachery Cogan, an internist, has with the Neptune Health Plan calls for Neptune to reimburse him under a typical PCP capitation arrangement. Dr. Cogan serves as the PCP for Evelyn Pfeiffer, a Neptune plan member. After hospitalizing Ms. Pfeiffer and ordering several expensive diagnostic tests to determine her condition, Dr. Cogan referred her to a specialist for further treatment. In this situation, the compensation that Dr. Cogan receives under the PCP capitation arrangement most likely includes Neptune's payment for


A.

All of the diagnostic tests that he ordered on Ms. Pfeiffer


B.

His visits to Ms. Pfeiffer while she was hospitalized


C.

The cost of the services that the specialist performed for Ms. Pfeiffer


D.

All of the above


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