Capitation and/or Delegation Supplement
Does this Supplement Apply to Me?
This supplement applies if you are a:
- Capitated provider.
- Delegated provider.
- Delegated Accountable Care Organization (ACO).
Topics in this Section
- Capitated Providers
- Delegated Providers and Accountable Care Organizations
- How to Contact Us
- Verifying Eligibility and Effective Dates
- Commercial Eligibility, Enrollment, Transfers, and Disenrollment
- Medicare Advantage (MA) Enrollment, Eligibility and Transfers, and Disenrollment
- Eligibility/Authorization Guarantee
- Provider Responsibilities
- Delegated Credentialing Program
- Virtual Visits (Commercial HMO Plans in California only)
- Referrals & Referral Contracting
- Medical Management
- Claims Processes
- Medicare Advantage (MA) Delegated or Capitated
- Claims Disputes and Appeals
- Contractual and Financial Responsibilities
- Capitation Payments and Reporting
- CMS Premiums and Adjustments
- Delegate Performance Management Program
- Appeals and Grievances