Capitation definition

Capitation means the reimbursement arrangement in which a fixed rate of payment per Enrollee per month is made to the Contractor for the performance of all of the Contractor’s duties and obligations pursuant to this Contract.

Capitation means a mechanism of payment in which a provider

Capitation means a uniform prepayment fee per Member per month, adjusted by age-sex, based on the Benefit Agreement issued to each Subscriber and the services due thereunder.

Examples of Capitation in a sentence

• HCA will provide the CONTRACTOR Capitation Rate signature sheets that detail the Capitation Rates and any add-on PMPM rate amounts by Rate Cohort on an annual basis or when Capitation Rates are revised during the term of this Agreement.

• HCA will change the Capitation Payment to the applicable blended Rate Cohort the month following the effective date of the NF LOC.

• Behavioral Health Capitation Rates are represented by the following Rate Cohorts: TANF/AFDC, all ages CISC, all ages SSI, 0-14 years SSI, 15-20 years SSI, 21+ years LTSS Medicaid Only LTSS Dual Eligible OAG BH 19-64 The CONTRACTOR shall ensure that all of the funding, through the Capitation Payments, is made available for Behavioral Health services.

• SDCB Capitation Rates are represented by Rate Cohorts Dual Eligible - Self Direction and Medicaid Only - Self Direction.

• The Capitation Rate includes Medicaid liability for Medicare deductible and co-insurance and any Medicaid Covered Services outlined in Attachment 1: Turquoise Care Covered Services that are not covered by Medicare.

More Definitions of Capitation

Capitation or “Capitation Payment” means the HIPAA 820 Premium Payment paid to MCOs, PAHPs, PACE organizations, and the NEMT broker.

Capitation means a method of compensating a

Capitation means a fixed per member, per month, payment or

Capitation means a method of payment in which HMO or a health care provider receives a fixed amount of money each month for each enrolled Member, regardless of the amount of covered services used by the enrolled Member.

Capitation means the mandatory administration fee included in a membership category.

Capitation means a per Member fixed fee amount that may be paid by Wellmark on behalf of Account to certain health care providers each month for certain Covered Services that may be provided to a Member. The Capitation amount may change during the term of this Agreement in accordance with agreements between Wellmark and the providers regarding payment and the scope of capitated services.

Capitation means a method of compensating a physician or provider for arranging for or providing a defined set of covered health care services to certain enrollees for a specified period that is based on a predetermined payment per enrollee for the specified period, without regard to the quantity of services actually provided.