The method whereby fees for the delivery of health care services in an organization are set after services are delivered is called:
A) Retrospective reimbursement
B) Prospective reimbursement
C) Fee-for-service
D) Capitation

Question

Quizplus · Accepted Answer

Retrospective reimbursement is the method whereby fees for the delivery of health care services are set after services have been delivered. This system is also known as "payment after the fact." The reimbursement is based on the actual cost of services provided during a specific period. The health care provider submits a bill for services rendered, and the payer reviews the bill and reimburses the provider for the services rendered. This may be done on a cost basis or on negotiated rates. Prospective reimbursement, on the other hand, is a method of setting fees for health care services before the services are delivered. Fee-for-service is a method of payment where providers charge separately for each service they provide. Capitation is a method of payment where providers are paid a fixed amount per member per month, regardless of the amount or type of services provided.

The Method Whereby Fees for the Delivery of Health Care