When a Health Care Provider Is Paid a Set Amount

question 41

Multiple Choice

When a health care provider is paid a set amount for each person covered by an insurance plan, regardless of how many services each person requires, this is called:

• A) capitation.
• B) co-pay.
• C) fee-for-service.
• D) negotiated fee.

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Definitions:

Quasi-Contract

An obligation imposed by law in order to prevent unjust enrichment, treated as a contract for the purpose of remedy despite the lack of a formal agreement.

Reasonable Value

is a legal concept referring to a fair or equitable monetary value or compensation for services, goods, or property, based on what a willing buyer would pay to a willing seller in a free market.

Enrichment

A benefit or advantage that one party gains, often at the expense of another, without offering compensation in certain legal contexts.

Quasi-contract

A legal concept where a court enforces an agreement between parties even though there is no actual contract between them, to prevent one party from being unjustly enriched.