Catalog Number : cga1746
Title : Understanding Prospective Payment Systems
Speaker : Duane Abbey

Webplay Recording Date : 9-14-2011
Webplay Price : $ 200 for two weeks viewing

Webinar Objectives:

• To review the scope and application of prospective payment systems
• To discuss the basic tenets of prospective payment systems
• To review the healthcare providers that are paid under fee schedule payment systems
• To discuss the concept of relative weights and their use in establishing prospective payment systems
• To discuss Medicare DRGs and APCs as the prime examples of prospective payment systems
• To explain how private third-party payers use prospective payment systems
• To review fee schedule payment for other types of services such as home health, skilled nursing, inpatient rehabilitation

Webinar Outline/Agenda:

• Prospective Payment
  • Basics of Prospective Payment Systems
  • Services Covered by Prospective Payment
  • Healthcare Providers That Utilize Prospective Payment
• Anatomy of a Prospective Payment System
  • Payment Is Fixed In Advance
  • Classification and Coding Systems
  • Relative Weights
  • Establishing Payment Levels
  • Private Third-Party Payer Use of Prospective Payment
  • Typical Alternatives to Prospective Payment
• Medicare Severity Refined Diagnosis Related Groups (MS-DRGs)
  • Special Features
  • Coding System
  • Grouping Process
  • Compliance Issues
• Medicare Ambulatory Payment Classifications (APCs)
  • Special Features
  • Coding Systems
  • Grouping Process
  • Compliance Issues
• Other Prospective Payment Systems
  • Skilled Nursing
  • Home Health
  • Inpatient Rehabilitation Facilities
• Sources for Further Information

Target Audience:

• Billing and Claims Transaction Personnel
• Chargemaster Coordinators
• Utilization Review Personnel
• Financial Analysts
• Compliance Personnel
• Physicians
• Internal Auditing Staff
• other interested personnel

Attendance Certificate:

Upon attending this course you will receive a 1.5 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.