Catalog Number : cbpa1098
Title : Basic Payment Systems
Speaker : Duane Abbey

Webplay Recording Date : 12-5-2008
Webplay Price : $ 150 for two weeks viewing

Webinar Presenter: Duane C. Abbey, Ph.D., CFP

Webinar Title: Basic Health Care Payment Systems

Webinar Level: Basic

Webinar Overview - General

A growing number of health care professionals around the country are increasingly frustrated by health care payment systems that do not reward efforts to improve health care quality, and that often penalize them financially. There is fairly widespread agreement that one reason for high costs and quality gaps is that current health care payment systems create penalties and disincentives across all elements of health care, including the prevention of illness, diagnosis, treatment of conditions, and the follow-up to care.

This Webinar is designed to introduce the health care payers and policymakers to the various types of health care payment systems. Dr. Abbey will discuss the fundamental concepts of claims filing and payment for health care services, summarize the differences between statutory and contractual payment processes and the general process of prospective payment systems.

Unfortunately, there are no easy answers regarding which options offer the best resolution for these many issues. Uncertainty exists due to the fact that there have been relatively few cases where significantly different payment systems have been attempted, and even fewer where thorough evaluations have been conducted. This Webinar leads to several conclusions about your next steps.

Webinar Objectives:

a. To introduce the various types of health care payment systems.
b. To discuss the fundamental concepts of claims filing and payment for health care services.
c. To review the terminology surrounding health care payment.
d. To appreciate the overall revenue cycle.
e. To understand the historical shifts in health care payment systems.
f. To appreciate the differences between statutory and contractual payment processes.
g. To understand the general process of prospective payment systems.

Webinar Outline/Agenda:

I. Overview of Health Care Payment Systems
  a. Retrospective Payment Systems
  b. Prospective Payment Systems
  c. The Revenue Cycle
  d. Statutory versus Contractual Payment Systems
II. Reimbursement Process
  a. Claims Filing
  b. Coding Systems
III. Retrospective Payment Systems
  a. Cost Based
  b. Charge Based
IV. Prospective Payment Systems
  a. Reimbursement Unit
  b. Classification System
  c. Adjudication Process and Edits
V. Governmental/Statutory Payment Systems
VI. Managed Care/Contractual Payment Systems

Prerequisites for Participating: None

Suggested Attendees: All hospital personnel who need to have a better understanding of the health care payment process and the varied payment systems that are used

Attendance Certificate: Upon attending this course you will receive a 2 Contact Hour Attendance Certificate. There is usually a reciprocal agreement between state associations to allow these to count for each state. If you have any questions, please ask your state association.

Full tuition is refunded immediately on request if the participant has not been sent the program materials and instructions. Once the instructions (including access codes) have been sent, a full refund will be issued only after the program runs and it is verified that the participant did not access the program.