Overview
Capitation & Risk Model Setup from Agile Nexus Solutions – handled by experienced US medical billing specialists, with clear reporting every month.
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Capitation & Risk Model Setup
Practices moving into capitated or value-based contracts.
Who it's for
Practices moving into capitated or value-based contracts.
How we do it
- 1We explain how the capitation or shared-risk model in your contract pays.
- 2We set up member lists, capitation payments and encounter reporting in your system.
- 3We track monthly capitation payments against your member roster.
- 4We report how the contract performs against fee-for-service.
Frequently asked questions
What is capitation?
A fixed monthly payment per member assigned to you, instead of a payment for each visit.
Do I still need to send claims under capitation?
Usually yes. Encounter data is still required for quality and risk reporting.
How do I know if a capitation contract is fair?
We compare the monthly payments with your expected cost and visit rates for those members.