Week 1 Checkpoint 1 Payment Methods

Week 1 checkpoint 1- Payment Methods. ResourceChapter 1 ofMedical Insurance An Integrated Claims Process climb Writeand post a 250- to 300- word response to the following questions ?Describe, the fee-for-service and capitation payment cycles. Include the relationship among provider, patient, and payer in your presentation, and their roles in the process. Fees for services be listed on the doctors fee schedule and there are known to be separate fees with each code and sometimes these codes are not billable.So in saying this the patient may have to pay some fees before they leave the doctors office because of some sort of procedure they had foundere. So the way the relationship goes for the fees for service is like this. The patient makes their usual monthly payments to their health plan or its set up to be automatically withdrawn from their paycheck. If they make their payments on time whence they can have medical services done by a physician.The patient then pays for any fees or co-pays for the medical services that were provided on that day and then the Medical Biller will then bill the health plan. The patient may be reimbursed for the some money they had to pay out of pocket. Capitation payment cycle is way different. Capitation means that there is a fixed prepayment that is paid to the medical provider for members of their plan for only necessary services provided to them. By using the capitation payment cycle the doctor may be taking risks for receiving fewer patients.Some doctors offices prefer this though because they are a small doctors office and only want to luck with people that have certain medical insurances so their biller and coder doesnt have to learn everything else. The only thing with this though is that they medical insurance is breathing out to pay the doctors office the same amount of money each month no matter what. This may cause problems for the patient because if they dont go see their doctor that month then they are still getti ng charged.