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Understanding the difference between “pay-for-performance” versus “pay for reporting,” and the difference between “prospective payment” versus “capitation” can be difficult. To be successful, organizations need to have a firm grasp of these concepts in addition to an understanding of the upcoming changes and challenges for health care billing in 2018. Many of these changes and challenges will involve a greater understanding of specific reimbursement methodologies based not only on the services provided, but also the related clinical outcomes. Most of these outcomes will affect one’s ability to be reimbursed for services rendered and care provided . . .

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