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The Empuls Glossary

Glossary of Human Resources Management and Employee Benefit Terms

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Reimbursement refers to how individuals or entities are compensated for expenses incurred or services rendered. In various industries, reimbursement plays a crucial role in ensuring fair compensation for goods or services provided, particularly in sectors such as healthcare, insurance, and finance.

What is reimbursement?

Reimbursement is the act of compensating someone for expenses they have incurred or losses they have suffered. In the healthcare industry, reimbursement holds paramount importance as it ensures that healthcare providers are adequately compensated for the services they offer to patients. 

This compensation not only covers the cost of medical treatments but also enables healthcare organizations to maintain operations, invest in technology, and attract skilled professionals. Moreover, reimbursement impacts patient access to quality care, as it influences the availability of healthcare services within communities.

What is a health reimbursement account (HRA)?

A health reimbursement account (HRA) is an employer-funded benefit plan that reimburses employees for qualified medical expenses not covered by their health insurance.

How to calculate mileage reimbursement?

Mileage reimbursement is typically calculated by multiplying the number of miles driven for business purposes by the reimbursement rate per mile set by the employer or the IRS.

Is mileage reimbursement taxable?

Mileage reimbursement for business purposes is generally not taxable if it doesn't exceed the IRS standard mileage rate. However, personal use of a company vehicle may be taxable.

What is tuition reimbursement?

Tuition reimbursement is a benefit offered by some employers to help employees cover the cost of education or training related to their job or career advancement.

Does mileage reimbursement include gas?

Mileage reimbursement usually covers all costs associated with using a personal vehicle for business purposes, including gas, maintenance, and wear and tear.

Listen, recognize, award, and retain your employees with our Employee engagement software  

Are reimbursements taxable?

Reimbursements for qualified business expenses are typically not taxable. However, reimbursements for non-business expenses may be subject to taxation.

Which states require cell phone reimbursement?

Several states have laws requiring employers to reimburse employees for work-related cell phone expenses. These states include California, Illinois, and Massachusetts, among others.

What is the mileage reimbursement rate for 2023?

The mileage reimbursement rate for 2023 can vary depending on the organization or the IRS. You would need to check with your employer or refer to the IRS website for the official rate.

Can I reimburse myself from HSA?

Yes, you can reimburse yourself from an HSA for qualified medical expenses that you have paid for out of pocket.

What is reimbursement in salary?

Reimbursement in salary refers to a portion of an employee's compensation that is paid to cover expenses they have incurred while performing their job duties, such as travel expenses or professional development costs. This reimbursement is usually included as part of the employee's regular salary or wages.

The reimbursement process typically involves several stages, including patient eligibility verification, claim submission, adjudication, payment processing, and handling denials and appeals. Each stage requires careful attention to detail and adherence to regulatory guidelines to ensure accurate and timely reimbursement.

What are the different types of reimbursement?

The different types of reimbursement are:

  • Direct reimbursement: Involves direct payment from the payer to the healthcare provider for services rendered.
  • Indirect reimbursement: Occurs when a third-party intermediary, such as an insurance company or government agency, reimburses the provider on behalf of the patient.
  • Third-party reimbursement: Refers to reimbursement facilitated by an entity other than the patient or healthcare provider, such as an insurance company or government agency.

What are the different types of reimbursement models?

Different reimbursement models are:

  • Fee-for-service (FFS): Providers are reimbursed based on the volume of services rendered, with payment for each specific service provided.
  • Capitation: Providers receive a fixed payment per patient enrolled, regardless of the number or type of services rendered.
  • Bundled payments: Involves a single payment for a bundle of services related to a particular episode of care, encouraging efficiency and coordination among providers.
  • Pay-for-performance (P4P): Providers receive incentives or penalties based on the quality and outcomes of care delivered.
  • Value-based reimbursement: Focuses on rewarding providers for delivering high-quality, cost-effective care, rather than the volume of services provided.

What are the general reimbursement processes?

The general reimbursement process takes place in the following way:

  • Patient eligibility verification: Ensuring that patients are eligible for reimbursement according to their insurance coverage or government programs.
  • Claim submission: Providers submit claims detailing the services provided to patients to initiate the reimbursement process.
  • Adjudication: Payers review claims to determine reimbursement amounts based on coverage policies, coding accuracy, and medical necessity.
  • Payment processing: Payers issue payments to providers for approved claims, typically through electronic funds transfer or paper checks.
  • Denials and appeals: Providers may contest claim denials through appeals processes to resolve disputes and obtain rightful reimbursement.

Employee pulse surveys:

These are short surveys that can be sent frequently to check what your employees think about an issue quickly. The survey comprises fewer questions (not more than 10) to get the information quickly. These can be administered at regular intervals (monthly/weekly/quarterly).

One-on-one meetings:

Having periodic, hour-long meetings for an informal chat with every team member is an excellent way to get a true sense of what’s happening with them. Since it is a safe and private conversation, it helps you get better details about an issue.


eNPS (employee Net Promoter score) is one of the simplest yet effective ways to assess your employee's opinion of your company. It includes one intriguing question that gauges loyalty. An example of eNPS questions include: How likely are you to recommend our company to others? Employees respond to the eNPS survey on a scale of 1-10, where 10 denotes they are ‘highly likely’ to recommend the company and 1 signifies they are ‘highly unlikely’ to recommend it.

Based on the responses, employees can be placed in three different categories:

  • Promoters
    Employees who have responded positively or agreed.
  • Detractors
    Employees who have reacted negatively or disagreed.
  • Passives
    Employees who have stayed neutral with their responses.

What are the challenges in reimbursement?

The challenges in reimbursement are:

  • Administrative burden: Complex billing processes and regulatory requirements can increase administrative workload for healthcare providers.
  • Coding and documentation Requirements: Accurate coding and documentation are essential for reimbursement, requiring ongoing training and resources.
  • Reimbursement rate fluctuations: Changes in reimbursement rates or policies can impact provider revenue and financial sustainability.
  • Fraud and abuse: Fraudulent billing practices and improper coding can lead to overpayment or denial of legitimate claims.
  • Compliance issues: Non-compliance with reimbursement regulations can result in penalties, audits, and legal repercussions for healthcare organizations.

How to be reimbursed from HSA (Health Savings Account)?

To be reimbursed from an HSA, you typically need to pay for qualified medical expenses out of pocket and then submit a reimbursement request to your HSA administrator along with receipts or documentation.

How does tuition reimbursement work?

Tuition reimbursement programs vary by employer but generally involve employees paying for eligible education expenses upfront and then submitting receipts or proof of payment to their employer for reimbursement.

Who are the key stakeholders in reimbursement?

The key stakeholders in the reimbursement process are:

  • Healthcare providers: Including hospitals, physicians, and other healthcare professionals who deliver services to patients.
  • Payers/insurers: Such as private insurance companies, Medicare, and Medicaid, responsible for reimbursing healthcare providers for covered services.
  • Patients: Individuals receiving healthcare services and often responsible for copayments, deductibles, or coinsurance amounts.
  • Government agencies/regulators: Entities responsible for regulating reimbursement policies, such as the Centers for Medicare & Medicaid Services (CMS) in the United States.

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