Remember two central ethical concerns: Undue inducement, meaning an offer so attractive it leads to bad judgment, and unjust inducement, meaning payment is more attractive to lower-income people, putting too much of the burden of research participation on them.
In this month’s issue, the conversation on healthcare reimbursement turns to the additional prospective payment systems found across the continuum of care. Prospective payment remains a way in which the Centers for Medicare & Medicaid Services can determine the rates for care based on predetermined amounts rather than on billing. The processes are similar to the use of the diagnosis-related groups in the acute care setting, with some differences.
This month will continue the discussion of healthcare reimbursement by third-party payers. We began last month with a review of the diagnosis-related groups (DRGs) and associated terminology. We will continue by reviewing how medical records are coded followed by the new MS-DRGs implemented in 2007.
Lawsuits allege charity care withheld from thousands of patients
November 13, 2017
Two recent lawsuits in Washington allege that hospitals withheld charity care from thousands of patients. This article will review steps patient access departments can take to comply with state and federal regulations.
Significant revenue could be lost if patient care isn’t closely managed
May 10, 2016
A growing number of patients are presenting to registration areas with capitated insurance plans. These plans allow payment of a flat fee for each covered individual, regardless of how much care the individual receives.
Self-pay patients are converted to some type of coverage 62% of the time at West Valley Medical Center in Caldwell, ID, reports patient access director Jennifer Bette. The department uses these approaches: