Which reimbursement methodology is characterized by billing for each individual service provided?

Study for the Healthcare Reimbursement Exam. Engage with flashcards and multiple-choice questions, each providing hints and explanations. Prepare effectively for your exam!

The reimbursement methodology characterized by billing for each individual service provided is fee-for-service. This approach allows healthcare providers to receive payment for each specific service rendered to patients rather than receiving a lump sum payment or a set fee for a period of care. Under the fee-for-service model, providers are incentivized to deliver more services, as their reimbursement is directly tied to the quantity of services rendered. This can include individual procedures, tests, consultations, and other forms of care.

In contrast, capitation involves a fixed payment for a defined period, regardless of the number of services used, shifting more financial risk to providers. The episode of care model focuses on payment for all services associated with a particular treatment or diagnosis during a set period, promoting care coordination but not billing for individual services. Cost-plus reimbursement allows providers to receive payment based on the actual costs incurred plus an additional amount for profit, which is not based on separate service billing. Each of these alternatives emphasizes different principles of cost control and care delivery, making fee-for-service distinct in its approach of itemizing each service provided.

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