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CostBased, ChargeBased, and Contractual Payment Systems (Healthcare Payment Systems),Used
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The fourth book in the Healthcare Payment System series, CostBased, ChargeBased, and Contractual Payment Systems compares costbased systems, chargebased payment approaches, and contractuallybased payment processes with feeschedule 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 costbased, chargebased, and contractual payment systems.The book illustrates essential concepts with a series of simple case studiesmaking it ideal for anyone interested in learning more about the specific systems and processes used for payment in healthcare services. It discusses Medicare costbased 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 costbased reimbursement systems Examines chargebased and contractual payment systems Describes where healthcare payment systems are headed in the futureSince 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 thirdparty administrators.
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This product may contain chemicals known to the State of California to cause cancer, birth defects, or other reproductive harm.
For more information, please visit www.P65Warnings.ca.gov.