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.

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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

• Capitation payments received prior to the effective date of loss of program authority that included costs for work specific to the program or activity that is no longer authorized, but that was performed prior to that effective date, may be retained by the Contractor and need not be returned to the State.

• Actual PPG gross Capitation shall fluctuate from month to month to the extent that PPG’s age, sex and benefit plan mix fluctuates.

• Each Capitation payment shall be accompanied by a remittance summary.

• Capitation Program Rates for Primary Care Entities, is hereby deleted and replaced with the attached Appendix L.

• The Contractor is responsible for payment even where an Enrollee changes their county of residence during the month that the Contractor received a Capitation Payment.

More Definitions of Capitation

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

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

Capitation means an arrangement whereby the amount of money paid to the provider network is based upon the agreement to provide certain health care services to covered persons but does not vary on the basis of the number or type of services actually rendered.

Capitation means a method of compensating a

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.