The Marble Health Plan sets aside a PMPM amount for each specialty. When a PCP in Marble's provider network refers a Marble plan member to a specialist and the specialist provides medical services to the member, the specialist begins to receive a share of those funds on a monthly basis. Marble determines the monthly payment for each specialist by dividing the number of active patients for that specialty by the total specialty pool for that month. This form of payment, which is similar to a case rate, is known as
A) Referral circle capitation
B) Risk pod capitation
C) Contact capitation
D) Retrospective reimbursement capitation
Correct Answer:
Verified
Q33: The Kayak Company self funds the health
Q34: The following statements are about various reimbursement
Q35: With regard to capitation arrangements for hospitals,
Q36: In order to calculate a simple monthly
Q37: Reconciliation is the process by which a
Q39: A stop-loss contract may provide that claims
Q40: One true statement about a type of
Q41: Under the alternative funding method used by
Q42: One law prohibits Dr. Laura Cole from
Q43: With regard to the Medicaid program in
Unlock this Answer For Free Now!
View this answer and more for free by performing one of the following actions
Scan the QR code to install the App and get 2 free unlocks
Unlock quizzes for free by uploading documents