Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:Introduction to Health Care and Public Health in the U.S.
Unit:Financing Health Care - Part 2
Lecture:The Revenue Cycle of Various Health Care Enterprises
Slide content:Reimbursement & Claims Reimbursement: Compensation or payment for health care services already provided Fee-For-Service Episode-of-Care Claim: Itemized statement and request for payment of the costs of health care services rendered by a health care provider or organization sent to third-party payor 8
Slide notes:Reimbursement is the term used to describe payment by third-party payors to health care organizations for services provided. Third-party payors reimburse claims based upon one of two methodologies: fee-for-service or episode-of-care, both of which describe a unit of payment. Reimbursement methodology will be discussed at length later in this unit. A claim is the health care organizations itemized statement and formal request for payment from the third-party payor for the medical services provided to the patient or the insured. 8