Which term describes the act of making a return payment to a provider or payer?

Which term describes the act of making a return payment to a provider or payer?

• A. Capitation
• B. Reimbursement
• C. MCOs
• D. FPL

Answer: (B)

Reimbursement describes payment that is returned or issued to the provider (or holder) after services are delivered or costs are incurred. In health care, after a claim is processed, the payer pays the provider for those services, which is the reimbursement. Capitation is a prepaid, fixed amount per patient per period, not a return payment. MCOs are organizations that manage care and payment arrangements, not the act of returning funds. FPL (federal poverty level) is a threshold used for eligibility, not a payment action.

Reimbursement describes payment that is returned or issued to the provider (or holder) after services are delivered or costs are incurred. In health care, after a claim is processed, the payer pays the provider for those services, which is the reimbursement. Capitation is a prepaid, fixed amount per patient per period, not a return payment. MCOs are organizations that manage care and payment arrangements, not the act of returning funds. FPL (federal poverty level) is a threshold used for eligibility, not a payment action.