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Prospective Payment Systems (Paperback, New)
Loot Price: R1,797
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Prospective Payment Systems (Paperback, New)
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The third book in the Healthcare Payment Systems series,
Prospective Payment Systems examines the various types of
prospective payment systems (PPS) used by healthcare providers and
third-party payers. Emphasizing the basic elements of PPS, it
considers the many variations of payment for hospital inpatient and
outpatient services, skilled nursing facilities, home health
agencies, long-term hospital care, and rehabilitation facilities
along with other providers. The book describes the anatomy of PPS,
including cost reports, adjudication features and processes,
relative weights, and payment processes. It outlines the features
and documentation requirements for Medicare Severity Diagnosis
Related Groups (MS-DRGs), the Medicare Ambulatory Payment
Classifications (APCs), Medicare HHPPS, Medicare Skilled Nursing
Resource Utilization Groups (RUGs), and private third-party payers.
Provides a framework for understanding and analyzing the
characteristics of any PPS Discusses Medicare prospective payment
systems and approaches Includes specific references to helpful
resources, both online and in print Facilitates a clear
understanding of the complexities related to PPS-covering specific
topics at a high level and revisiting similar topics to reinforce
understanding Complete with a detailed listing of the acronyms
most- commonly used in healthcare coding, billing, and
reimbursement, the book includes a series of case studies that
illustrate key concepts. It concludes with a discussion of the
challenges with PPS-including compliance and overpayment issues-to
provide you with the real-world understanding needed to make sense
of any PPS.
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