Providers that use the capitation model have a stake in keeping their patients well and avoiding expensive procedures. When a patient receives a charge from a provider, it is known as fee-for-service billing. Patients may, however, also be liable for paying some out-of-pocket costs, such deductibles, copays, or coinsurance. Using a predetermined charge schedule, medical professionals can bill patients using the retrospective payment billing approach. HMOs limit patients to a network of healthcare providers while offering full services at lower costs. Private insurance is typically provided by employers or purchased by individuals on the open market. In the US, who covers the medical bills? It depends, is the response. This billing method, which is frequently employed by HMOs, is intended to encourage physicians to keep patients healthy and avoid expensive medical procedures.
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