Please check my answer thanks :)
True or False
If an enrollee uses more services then first thought they would per the PPOM calculation then the plan would show a loss for that period
I said True
true
According to my Googling of the abbreviation PPOM, it is a specific Preferred Provided Organization health plan. Whether they lose money or not depends upon how much they charge each employee or his/her insurer to belong, as well as how much services they use (less copayaments). They should have priced in a certain expected profit to start with.
So my answer would be "not necessarily"
To check the accuracy of your answer, let's break down the question and process the information given.
The question states, "If an enrollee uses more services than initially expected according to the PPOM (Per Person Overall Maximum) calculation, then the plan would show a loss for that period. True or False?"
To determine the correct answer, we need to understand the concept of PPOM. The PPOM is a calculation that determines the maximum amount a health plan would pay per enrollee for covered services within a specific period.
If an enrollee uses more services than what was calculated under the PPOM, it means that the health plan would spend more money on providing those services than anticipated. Consequently, the extra cost would lead to a financial loss for the plan during that period.
Therefore, based on this understanding, the correct answer is:
True.
Your initial response of "True" is correct.