When a member switches PCP’s, which provider receives the capitation for that month?
Capitation payments are prorated on a daily basis and are computed on the member’s effective date of eligibility with the PCP. Regardless of when, during a month, a member changes PCPs, each PCP will receive capitation for each day the member was assigned to him/her. In the same way, the capitation payment of a newborn will be prorated from the date of birth.
