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under a fee-for-service plan, the third-party payer makes a payment mul…

Question

under a fee-for-service plan, the third-party payer makes a payment

multiple choice

before medical services are provided.

after medical services are provided.

at the time of the visit.

once a month under a pmpm.

Explanation:

Define fee-for-service model

Under a fee-for-service (FFS) healthcare plan, services are unbundled and paid for separately. Payment is made only after the specific medical services have been rendered and a claim is submitted.

Compare with other payment models

Pre-payments (before services) or fixed monthly payments (PMPM - per member per month) are characteristic of capitation models, not fee-for-service.

Select the correct option

Since payments are issued in response to claims filed for completed treatments, the third-party payer makes the payment after medical services are provided.

Answer:

  • (A) before medical services are provided
  • (B) after medical services are provided (Correct answer)
  • (C) at the time of the visit
  • (D) once a month under a PMPM