Payment Methods Presentation

Payment Methods Presentation - Payment methods Click to...

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Unformatted text preview: Payment methods Click to edit Master subtitle style 5/9/11 Overview Fee-for-service Capitation Payment Cycles Relationship among provider, patient, and payer 5/9/11 Fee-for-Service {AFDFDDCD-94F7-4797-8385-E4ED0E4095E8} {1D3D4CB4-DC14-4169-B8B4-A0CA5A10E02E} {C3DF1E5D-50D9-406E-B6DD-A812823F1F12} party Provider First Pays for services party Insurance received Provides specialist Patient medical services Reimburses provider on behalf employer ealth Policyholder or of Third party H Files patient claims plan Pays premium Reimburses medical expenses 5/9/11 {57134342-4FF4-4B22-9246-0179EADF06CD} Capitation Payment Cycles {A4C35BF1-E26C-4B79-BD54-5670F71A10F5} {E3C0F47F-8639-4605-9BDF-0150DD21988B} Patient Second party Policyholder Prepays capitated rate for Provides employernsurance specialist FilesI Provider or Third partymedical expenses medical encounter services data Health p Pays premium 5/9/11 Provider Relationship Meet medical necessities Consistent professional standards of service Provider’s include: Physicians nurse-practitioners Therapists Hospitals Laboratories Pharmacies 5/9/11 Patient Relationship Pays for health plan through payer Patient pays deductible/co-pay to provider for services Patient goes to provider to seek services 5/9/11 Payer Relationship Provide a variety of insurance products and different levels of coverage for various prices. Provide services to patients Make payments to providers 5/9/11 Conclusion Patients pay for health care benefits Payers provide benefits plans to patients Payers provide health plans for prepayment of services to the providers 5/9/11 ...
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This note was uploaded on 05/09/2011 for the course HCR 220 taught by Professor Cvibanez during the Winter '10 term at University of Phoenix.

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Payment Methods Presentation - Payment methods Click to...

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