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Secondary capitation is a relationship arranged by a managed care organization between a physician and a secondary or specialist provider, such as an X-ray facility or ancillary facility such as a durable medical equipment supplier whose secondary provider is also paid capitation based on that PCP's enrolled membership.
Medical billing, a payment process in the United States healthcare system, is the process of reviewing a patient's medical records and using information about their diagnoses and procedures to determine which services are billable and to whom they are billed. [1] This bill is called a claim. [2]
In the United States, direct primary care (DPC) is a type of primary care billing and payment arrangement made between patients and medical providers, without sending claims to insurance providers. It is an umbrella term , incorporating various health care delivery systems that involve direct financial relationships between patients and health ...
Unlike PPOs, however, HMOs often require members to select a primary care physician (PCP), a doctor who acts as a gatekeeper to direct access to non-emergency medical services, and are required to first obtain a referral from their PCP in order to be reimbursed for the cost of medical services inside of their network of designated doctors and ...
Like all debt, medical debt left behind after your death is paid by your estate. The debt goes to the person handling your estate — called an executor. The executor’s job is to manage the ...
Medical care ratio (MCR), also known as medical cost ratio, medical loss ratio, and medical benefit ratio, is a metric used in managed health care and health insurance to measure medical costs as a percentage of premium revenues. [1]
Democratic Rep. Nancy Pelosi, 84, underwent a successful hip replacement surgery after falling while in Luxembourg with a congressional delegation, her office said Saturday. "Earlier this morning ...
Don’t leave your family unprotected — find life insurance coverage up to $2 million with no medical exam ... a new student loan repayment plan, the SAVE Plan, that cut monthly payments from ...