Cost-Based, Charge-Based, and Contractual Payment Systems - Couverture souple

Abbey, Duane C.

Couverture souple

ISBN 10 : 1439872996 ISBN 13 : 9781439872994

Editeur : Productivity Press, 2012

Synopsis

The fourth book in the Healthcare Payment System series, Cost-Based, Charge-Based, and Contractual Payment Systems compares cost-based systems, charge-based payment approaches, and contractually-based payment processes with fee-schedule payment systems and prospective payment systems. Supplying readers with a clear understanding of important background material on the different types of healthcare providers, it covers the basics of cost-based, charge-based, and contractual payment systems.

The book illustrates essential concepts with a series of simple case studies—making it ideal for anyone interested in learning more about the specific systems and processes used for payment in healthcare services. It discusses Medicare cost-based payment systems, Medicare payment approaches, and includes an appendix that outlines the various Medicare payment systems. Demystifying contractual language, it outlines managed care contracts and also:

• Delves into the intricacies involved with adjudication of claims
• Considers capitated payment systems
• Addresses healthcare costs and cost-based reimbursement systems
• Examines charge-based and contractual payment systems
• Describes where healthcare payment systems are headed in the future

Since compliance is inherent throughout the process of providing services, filling claims, and receiving payment, the book examines the range of compliance concerns, including statutory, contractual, and overpayment issues. Using numerous examples to illustrate the processes used for capitated contract arrangements, the book includes coverage of claim adjustment, managed care contracts, and the various combinations of payment systems used by third-party administrators.

A propos du livre

À propos de l'auteur

Duane C. Abbey

Détails de l'édition

• Éditeur: Productivity Press
• Date d'édition: 2012
• Langue: anglais
• ISBN 10: 1439872996
• ISBN 13: 9781439872994
• Reliure: Broché
• Numéro d'édition: 1
• Nombre de pages: 161
• Coordonnées du fabricant: non disponible
• Personne responsable: non disponible