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Did You Know?
December 22, 2009, Volume 56, No. 16

“Did You Know” is a monthly series that includes valuable tips to help you get the most out of the benefits and services offered by the Division of Human Resources.

The ABCs of Health Care

Understanding every facet of today’s health care system can be daunting. But it’s important for you to familiarize yourself with some of the standard terminology used in the health care industry, especially when it can save you money. For instance, using a capitated site when you receive medical services is important, but first you need to know what that means.

Used in HMO (Health Maintenance Organization) plans, capitation is the amount of money the plan pays your primary care physician (PCP) each month as a prepayment for prescribed medical services. A capitated site refers to the location your PCP has designated as his or her x-ray and lab site, or to the location of other providers who fall under his or her capitation. For example, when your PCP prescribes lab work for you, you should have it done at a location where he or she is capitated. Otherwise, you’ll be responsible for the full cost of the service.

The same holds true when you visit a specialist—any testing or treatment your specialist recommends must be completed at your PCP’s capitated site, or it will not be covered. Remember to always confirm all capitated sites with your PCP before using them.

If you have more specific questions about Penn’s health care benefits, visit the Human Resources website at www.hr.upenn.edu/benefits or contact the Penn Benefits Center at 888-PENN-BEN (888-736-6236).

—Division of Human Resources


Almanac - December 22, 2009, Volume 56, No. 16