HLTHAGE 2F03 Lecture Notes - Lecture 4: Copayment
19 Jan 2018
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Document Summary
Payment methods: ffs - physicians are paid for every service and test that they provide based on the usual and customary charges of physicians in the local area. Capitation - physicians are paid a fixed amount per enrollee, not per service, on a monthly basis. There are 200 patients/enrollees, 100 of these enrollees make a total of 200 office visits to physician over one year and each visit is reimbursed at (based on the 2015 fee schedule). Canada: deductible, a form of cost-sharing that requires an individual to pay the full cost of services received until the individual"s spending has reached a specified limit. Deductible: the insurance deductible is the amount of money you will pay in an insurance claim before the insurance coverage starts paying you. The percentage of costs of a covered health care service you pay (20%, for example) after you"ve paid your deductible.
