Common use of CAPITATION AMOUNTS Clause in Contracts

CAPITATION AMOUNTS. 13.1.1 TDH will pay HMO monthly premiums calculated by multiplying the number of Member months by Member risk group times the monthly capitation amount by Member risk group. For additional information regarding the actuarial basis and methodology used to compute the capitation rates, please reference the waiver under the document titled "Actuarial Methodology for Determination of Maximum Monthly Capitation Amounts". HMO and network providers are prohibited from billing or collecting any amount from a Member for health care services covered by this contract, in which case the Member must be informed of such costs prior to providing non-covered services.