• Outbound: PCP, specialist, hospital and ancillary capitation
• Inbound: Government program and medical group revenues
  

The capitation module supports both outbound payment processing and inbound revenue reconciliation that enable managed care organizations to effectively manage delegated risk.

• Ensures accurate processing for any capitation method
  
  
• Calculates PMPM capitation using age, sex, and benefit-weighted rates, and it supports percent-of-premium capitation method
  
  
• Links a schedule of capitated services automatically to the claims system, ensuring that capitated services are processed as encounters and claims are paid only for non-capitated services
  
  
• Simplifies inbound capitation by reconciling capitated income to enrollment files on a member-by-member and month-by-month basis