What type of payment arrangements are made to prevent beneficiaries from paying out of pocket initially?

Conditional payments represent a specific type of payment arrangement designed to protect beneficiaries from having to pay out of pocket at the onset of receiving care. This type of arrangement is typically seen in situations involving Medicare and Medicaid, where payments are made on behalf of beneficiaries when they are eligible for coverage, even if the ultimate determination of coverage has not yet been established.

By using conditional payments, a health care provider can receive reimbursement while the patient's eligibility for insurance coverage is being verified. This ensures that beneficiaries can access necessary medical services without the burden of upfront payments, which might present a financial barrier to care.

In contrast, capitated payments involve a fixed amount paid to providers per patient, retrospective payments occur after services are rendered based on actual costs, and pre-authorized payments require prior approval for services before payment can be approved. While each of these methods has its specific use cases, they do not primarily focus on preventing out-of-pocket costs at the time of service in the direct manner that conditional payments do.