Recruiter's Glossary

Examples: Eligibility Verification • Mental Health Parity • Coordination of Benefits

Fee-for-Service

Term from Health Insurance industry explained for recruiters

Fee-for-Service is a traditional way of billing in healthcare where providers charge separately for each service they perform. Think of it like a restaurant bill where every item is listed separately - each doctor visit, test, or procedure has its own charge. This differs from other payment models like HMOs or bundled payments. When reviewing resumes in healthcare, this term often appears when candidates have experience with billing, claims processing, or healthcare administration.

Examples in Resumes

Processed over 500 monthly Fee-for-Service claims with 99% accuracy rate

Managed billing department handling both Fee-for-Service and managed care claims

Trained staff on Fee-For-Service billing procedures and Medicare guidelines

Typical job title: "Healthcare Billing Specialists"

Also try searching for:

Medical Biller Claims Processor Healthcare Claims Specialist Insurance Billing Coordinator Medical Billing Specialist Healthcare Revenue Cycle Specialist Insurance Claims Analyst

Where to Find Healthcare Billing Specialists

Professional Organizations

Job Boards

Online Communities

Example Interview Questions

Senior Level Questions

Q: How would you handle a situation where a large number of Fee-for-Service claims are being denied?

Expected Answer: A senior professional should discuss systematic approach to analyzing denial patterns, implementing corrective measures, staff training needs, and communication strategies with both insurance companies and healthcare providers.

Q: What strategies have you implemented to improve Fee-for-Service collection rates?

Expected Answer: Should explain experience with implementing verification processes, staff training programs, using billing software effectively, and developing relationships with insurance companies to resolve issues quickly.

Mid Level Questions

Q: What are the main differences between Fee-for-Service and Managed Care billing?

Expected Answer: Should explain how Fee-for-Service bills for each individual service while managed care often has pre-negotiated rates and packages, plus discuss the different processing requirements for each.

Q: How do you ensure accurate coding for Fee-for-Service claims?

Expected Answer: Should discuss verification of documentation, proper use of coding guidelines, regular updates on coding changes, and quality checking processes.

Junior Level Questions

Q: What is Fee-for-Service and how does it work?

Expected Answer: Should be able to explain that it's a payment model where each service is billed separately, give basic examples of how services are coded and billed, and understand the basic claim submission process.

Q: What information is required on a Fee-for-Service claim?

Expected Answer: Should list basic components like patient information, service codes, diagnosis codes, provider information, and dates of service.