The fee - the patient will have to make if there is one The...

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The fee-for-service Capitation payment cycles. The relationship among provider, patient, and payer, and their roles in the process Fee-For-Service (FFS) is when medical office is paid for a certain amount for each service provided to a patient that comes in FFS is used with or without a contract between the insurance company and provider. Capitation payment cycles are payments agreed upon by a health insurance company and a medical provider. It is a fixed, pre-arranged monthly payment received by a physician, clinic or hospital per patient enrolled in a health plan with a capitated contract The relationship among providers, patient, and payers, and their roles in the process is a simple one. When the patient arrives at a providers office they are asked about insurance and if they have insurance the office will verify what is covered for the patient and what kind of copayment
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Unformatted text preview: the patient will have to make if there is one. The provider will then mark the appropriate codes for the patients charge and bill to the payers or patient’s insurance company, whatever is not paid by the payer, it will be sent to the patient and they will have to pay the bill. If the patient does not have insurance they will be billed the full amount and can discuss with the providers what type of payment arrangements can be made if the balance cannot be paid in full at the time of the service. The fee-for-service and capitation payment cycles and their relationship among providers, patients, and payers, and their roles in the process was made possible to make sure that the best possible care is to be provided to the patients that come into the providers office on a daily basis....
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