CPB (Certified Professional Biller) Certification Practice Exam

What does capitation involve in healthcare services?

1. Payment per Visit

2. Hourly Payment

3. Salary Payment

4. Preestablished Payments over Time

The correct answer is: Preestablished Payments over Time

Capitation involves a payment model where healthcare providers receive a pre-established amount of money for each enrolled patient over a specified period, regardless of the number of services provided or visits made during that time. This system incentivizes providers to focus on delivering preventive care and managing patients' overall health rather than simply responding to individual services or visits. It aims to control healthcare costs while ensuring that patients receive adequate care. The other payment models mentioned, such as payment per visit, hourly payment, and salary payment, do not account for the same structure or intention behind capitation. Instead, they generally pay based on the volume of services provided or time spent on care, which is fundamentally different from the capitation approach that focuses on comprehensive patient management over a designated time frame.