Capitation: It is defined as prepayment for services to the provider in all cases either get no service or need intensive service
Fee for service: is a type of the payment model for payment towards the healthcare services separately.
Withholds: This is the percentage of primary care capitation which is withheld every month P4P: is known as Pay-for-Performance is the type of Value-Based Purchasing
Global capitation: In this the payment is done to a single entity towards all medical services in terms of single capitation but manages all the care services.
RVS: known as relative value scale each characterized by the relative value
RBRVS: Known as resource-based relative value scale
Usual, customary or reasonable: In this payment system the physicians are paid till the prevailing fee that is calculated by the percentiles of physician charges on the variable markers
Stop loss: it’s a type of outlier risk analysis
define these terms!! Capitation . Fee for Service . Withholds P4P . Global capitation . RVS...
Please define it in your own words Network Hold Harmless No balance billing Coordination of benefits Carve Out Services Hospitalist National Practioner Data Bank National Provider Identifier Capitation .Fee for Service Withholds P4P Global capitation RVS RBRVS Usual, customary or reasonable Reimbursement methods . Stop Loss . Chargemaster Straight charges . Discount on chorges Straight discount on chorges . Sliding scole discount on charges Per Diem Charges Straight per diem chorge Stiding per diem Differential by doy in hospitol Diagnosis...
Please define on your own words! National Practioner Data Banlk National Provider Identifier Capitation Withholders P4p Global Capitation 50 ward
Explain the differences between HMO's, and PPO's, capitation, and fee for service. Include pros and cons of each. Define insurance plan terms including: deductibles, coinsurance, copays, and allowed amounts.
Explain the differences between HMO's, and PPO's, capitation, and fee for service. Include pros and cons of each. Define insurance plan terms including: deductibles, coinsurance, copays, and allowed amounts.
The Cost of the U.S. Health Care System Describe three different reimbursement methods (e.g., capitation, fee-for-service [FFS], pay-for-performance [P4P], value-based, episode of care, prospective reimbursement, diagnosis related group [DRG], patient-centered medical home [PCMH]). Explain why you think one of the reimbursement methods you discussed is more effective at reducing health care costs overall while still ensuring the delivery of quality care. Describe the use of two technological advancements (e.g., electronic medical record [EMRs], electronic health records [EHRs], medical research, improved...
Define each of the following terms used regularly by the major third-party payers, and explain how they are supposed to affect providers' incentives, fees, and overall utilization: a. fee-for-service b. assignment c. capitation d. risk sharing This is for my Healthcare Economics class.