AHIP Health Plan Finance and Risk Management AHM-520 Question # 78 Topic 2 Discussion
AHM-520 Exam Topic 2 Question 78 Discussion:
Question #: 78
Topic #: 2
Reconciliation is the process by which a health plan assesses providers' performance relative to contractual terms and reimbursement.
With regard to this process, it can correctly be stated that
A.
Areconciliation typically includes payment to the providers of any withholds or bonuses due to them
B.
Ahealth plan typically should conduct a reconciliation immediately after the evaluation period has ended
C.
Most agreements between health plans and providers require reconciliations to be performed quarterly
D.
Ahealth plan typically should not conduct reconciliation for a provider until the plan has received all claims or other documentation of services that the physician provided during the evaluation period
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