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HMOs Unique Features And Lingo


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Under traditional indemnity insurance, the insurance company pays a doctor or hospital for each service provided. This is called fee-for-service.

Under Capitation, the doctor or other medical provider receives a monthly payment for each HMO member (patient) registered with it. It doesn't matter whether the provider sees or treats the patient one time a month or many times, or even has no contact with the member at all. 

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