Question: 36. A primary care physician accepted a contract with a health plan that paid a capitation rate of $40 PMPM. Under the contract, there are
36. A primary care physician accepted a contract with a health plan that paid a capitation rate of $40 PMPM. Under the contract, there are no additional services paid outside of the capitation rate. The physician has 1,000 of the health plans members assigned to him/her as the primary care physician. Assuming the physician is the PCP for all 1,000 members each month for the year, what will be the total payment for the physician from the health plan for the year for these 1,000 members.
A. $480,000
B. $40,000
C. $100,000
D. $150,000
45. Total Medical Cost = Unit Cost x Z + Administrative Expense. Z is which of the following:
A. Premium Expense
B. Contract Rate
C. Case Management Expense
D. Utilization
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