See: federally qualified health center (FQHC) .
Insurance Encyclopedia
federally qualified health maintenance organization (FQHMO)
Health maintenance organization that applies and meets the requirements of the Centers for Medicare and Medicaid Services (CMS) guidelines for Medicare reimbursement as set forth in the Health Maintenance Organization Act of 1973. Staff, group, and independent practice association (IPA) model HMOs are eligible for federal qualification under the federal HMO law. Network model HMOs are usually not eligible for qualification. FQHMOs are eligible for selection by a company of more than 25 employees and the company must offer two types (i.e., one IPA and one group or staff model HMO). This is known as the “dual choice mandate” of the HMO law. FQHMOs are eligible to contract with Medicare to be reimbursed on a per capita basis for an amount equal to 95% of its estimated cost for total health care services to that person during the year.
Fee
Dollar amount for professional services rendered to a patient by a provider.
Fee allowance
See: fee schedule .
Fee disclosure
Communication of medical charges with a patient by a provider or office manager before medical services and treatment are rendered.
Fee for service
Where a broker is remunerated on the basis of a fee agreed with its client instead of brokerage. The benefit to the broker is that, subject to the terms of agreement, the fee will be payable whether or not cover is placed whereas brokerage is only payable in respect of the placement of cover.
Fee for service reimbursement (Health Insurance)
A system wherein doctors and other health care professionals receive payment based on their charges for services provided.
Fee freeze
To fix prices at a given level or place for a specific period of time.
Fee maximum
See: fee schedule .
Fee maximum (Health Insurance)
The maximum fee available to a health care professional for a service provided under a contract.