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

• Their function is to organize and directly or indirectly guarantee the delivery of the POS to beneficiaries, and to bill the FOSYGA for the difference between the income from subscriber premiums and the value of the corresponding Capitation Payment Units (UPC).

• Each subscriber is allocated a certain amount of resources (Capitation Payment Unit (UPC)), estimated according to socioeconomic conditions.

• As outlined on previous slides, only a subset of conditions map to the CMS-HCC Risk Adjustment model.4On March 31, 2023, CMS released the final Announcement of Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (Final Rate Announcement).

• Activity As indicated in the CMS “Announcement of Calendar Year (CY) 2013 Medicare Advantage Capitation rates and Medicare Advantage and Part D Payment Policies and Final Call Letter” released on April 2, 2013, CMS Medicare Marketing Guidelines do not apply to communication by State governments and materials created by the State do not need to be reviewed or submitted in HPMS.

• Where evidence to substantiate the validity of payments cannot be found, any fees paid will be recovered.Capitation & Continuing Care Capitation and continuing care payments are based on the numbers and ages of the patients registered with the dentist.

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 the reimbursement arrangement in which a fixed rate of payment per Enrollee per month is made, regardless of whether the Enrollee receives Covered Services in that month, to Contractor for the performance of all of Contractor’s duties and responsibilities pursuant to the Contract.‌

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

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 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 method of compensating a