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Grade 9 out of a maximum of 10 (90%)
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Question1
Marks: 1
Dr. Elizabeth Brennan does not contract with the PFFS plan but accepts the plan’s terms and conditions
for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr. Brennan charge?
AHIP HEALTHCARE
,AHIP Final Exam verified Questions with Verified Answers |100% Correct
|Already Graded A+ (Latest 2025/2026 Update)
Choose one answer.
a. Dr. Brennan can charge Mary no more than the cost sharing
specified in the PFFS plan’s terms and conditions of payment
which may include balance billing up to 25 percent of the Medicare
rate.
b. Dr. Brennan can charge the beneficiary the same costsharing as
Original Medicare as long as she sends the claim to Medicare and
not the plan.
AHIP HEALTHCARE
,AHIP Final Exam verified Questions with Verified Answers |100% Correct
|Already Graded A+ (Latest 2025/2026 Update)
c. Dr. Brennan can charge Mary Rodgers more than the cost
sharing specified in the PFFS plan’s terms and conditions as long
as she treats all beneficiaries the same.
d. Dr. Brennan can charge Mary Rogers no more than the cost
sharing specified in the PFFS plan’s terms and condition of payment
which may include balance billing up to 15 percent of the Medicare
rate.
Correct
Marks for this submission: 1/1.
Question2
AHIP HEALTHCARE
, AHIP Final Exam verified Questions with Verified Answers |100% Correct
|Already Graded A+ (Latest 2025/2026 Update)
Marks: 1
Mrs. Davenport enrolled in the ABC Medicare Advantage (MA) plan several years ago. Her doctor
recently confirmed a diagnosis of end-stage renal disease (ESRD). What options does Mrs. Davenport
have in regard to her MA plan during the next open enrollment season?
Choose one answer.
a. She must immediately drop her ABC MA plan and enroll in a
Special Needs Plan (SNP) for individuals suffering from ESRD if one is
AHIP HEALTHCARE
|Already Graded A+ (Latest 2025/2026 Update)
Grade 9 out of a maximum of 10 (90%)
Feedback You have completed this Knowledge Check. To proceed, please return to the training dashboard
and select the next availa
Question1
Marks: 1
Dr. Elizabeth Brennan does not contract with the PFFS plan but accepts the plan’s terms and conditions
for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr. Brennan charge?
AHIP HEALTHCARE
,AHIP Final Exam verified Questions with Verified Answers |100% Correct
|Already Graded A+ (Latest 2025/2026 Update)
Choose one answer.
a. Dr. Brennan can charge Mary no more than the cost sharing
specified in the PFFS plan’s terms and conditions of payment
which may include balance billing up to 25 percent of the Medicare
rate.
b. Dr. Brennan can charge the beneficiary the same costsharing as
Original Medicare as long as she sends the claim to Medicare and
not the plan.
AHIP HEALTHCARE
,AHIP Final Exam verified Questions with Verified Answers |100% Correct
|Already Graded A+ (Latest 2025/2026 Update)
c. Dr. Brennan can charge Mary Rodgers more than the cost
sharing specified in the PFFS plan’s terms and conditions as long
as she treats all beneficiaries the same.
d. Dr. Brennan can charge Mary Rogers no more than the cost
sharing specified in the PFFS plan’s terms and condition of payment
which may include balance billing up to 15 percent of the Medicare
rate.
Correct
Marks for this submission: 1/1.
Question2
AHIP HEALTHCARE
, AHIP Final Exam verified Questions with Verified Answers |100% Correct
|Already Graded A+ (Latest 2025/2026 Update)
Marks: 1
Mrs. Davenport enrolled in the ABC Medicare Advantage (MA) plan several years ago. Her doctor
recently confirmed a diagnosis of end-stage renal disease (ESRD). What options does Mrs. Davenport
have in regard to her MA plan during the next open enrollment season?
Choose one answer.
a. She must immediately drop her ABC MA plan and enroll in a
Special Needs Plan (SNP) for individuals suffering from ESRD if one is
AHIP HEALTHCARE
