Building global billing and payment systems.

Abstract

Global fees for episodes of care is perhaps one of the most progressive risk-based contracting techniques to emerge in managed care. Although global fees are theoretically a far more advanced and efficient payment technique than either fee-for-service or capitation, the chief obstacle preventing their implementation is the archaic billing and claims transaction systems operating in most "modern" health plans, hospitals, and physician offices. This article discusses various billing techniques available to interested parties who desire to enter into episode of care contracting venues.