Medicare pays on a fee for service basis. This means every time an APN makes a visit, Medicare is billed and the APN gets paid. Managed care companies may be in a capitation arrangement with the practice. This means that for each member, the practice is paid a preset amount per month. All patient costs and provider costs are paid from this capitation.
Alternatively, a managed care company may negotiate a set contract with a provider group, to provide care to a group of patients. As mentioned earlier, each insurer may have a different arrangement, as far as how they reimburse advanced practitioners. Some insurers may be better than others in terms of paying claims in a timely manner.