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Health Care Glossary

Health Care Glossary


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Published by: db_sheetal on Feb 05, 2009
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Portion of a claim deducted and held by a health plan before payment is made to a
capitated physician. A form of compensation whereby a health plan withholds payment to
a provider until the end of a period at which time the plan distributes any surplus based
on some measure of provider efficiency or performance. That portion of the monthly
capitated payment to providers withheld by the MCO to create an incentive for efficient
or reduced utilization of care or services. A provider that exceeds their withhold amount
does not receive a dispersion at the end of the contract period. See also PCR or physician
contingency reserve.

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