Which plan reimburses providers after services are rendered using a submission and reimbursement process, often based on charges?

Which plan reimburses providers after services are rendered using a submission and reimbursement process, often based on charges?

• A. Indemnity
• B. Capitation
• C. Fee for service
• D. Sliding scale

Answer: (A)

Post-service reimbursement through a claims submission is how indemnity plans operate. After a patient receives care, the provider bills the insurer, and the plan reimburses based on the submitted charges or an established allowable amount, with the patient often responsible for any remaining balance. This is different from capitation, where a fixed amount is paid per enrolled patient per period regardless of services, and from sliding-scale arrangements, where fees are adjusted based on income. While fee-for-service describes paying for each individual service, indemnity is the plan type that uses post-service claims and charge-based reimbursement.

Post-service reimbursement through a claims submission is how indemnity plans operate. After a patient receives care, the provider bills the insurer, and the plan reimburses based on the submitted charges or an established allowable amount, with the patient often responsible for any remaining balance. This is different from capitation, where a fixed amount is paid per enrolled patient per period regardless of services, and from sliding-scale arrangements, where fees are adjusted based on income. While fee-for-service describes paying for each individual service, indemnity is the plan type that uses post-service claims and charge-based reimbursement.