Prospective Payment Systems - Duane C. Abbey - Böcker - Taylor & Francis Inc - 9781439873014 - 15 februari 2012
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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.


219 pages, 4 black & white illustrations, 15 black & white tables

Media Böcker     Pocketbok   (Bok med mjukt omslag och limmad rygg)
Releasedatum 15 februari 2012
ISBN13 9781439873014
Utgivare Taylor & Francis Inc
Antal sidor 224
Mått 177 × 251 × 13 mm   ·   446 g
Språk Engelska  

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