Physician Contingency Reserve. See withhold.
Physician Contingency Reserve. A portion of the claim which is deducted and withheld by the health plan before payment is made to the physician. It serves as an incentive for proper quality and utilization of health care. A portion of this reserve may be returned to the physician or to pay claims where the plan needs additional funds. It is also sometimes called "withhold." (H)
physician contingency reserve. the "at-risk" portion of a claim that is deducted and withheld by the health plan before payment is made to a participating physician as an incentive for appropriate utilization and quality of care. This amount - for example, 20% of the claim - remains within the plan and is credited to the doctor's account. The withhold can be used in instances when claims costs exceed the health plan's budget for a particular period. The withhold may be returned to the physician in varying levels which are determined based on analysis of performance or productivity compared against peers. Also called physician contingency reserve