Discussion Post #`1
In this Discussion, review the following concepts pertaining to Medicare-Medicaid prospective payment systems for post-acute care (PAC): Post-acute care (PAC) provides patients with healthcare services for their recuperation and rehabilitation after an illness or injury.
- Name the three dimensions of case mix measured using data elements from OASIS for the home health prospective payment system and provide detail explanation for each.
- Explain how the utilization review process supports the payment system
Discussion Post #2
In this Discussion, review the following concepts pertaining to revenue cycle management: To maintain profitability under the prospective payment systems, healthcare facilities are incentivized to constantly examine and implement methods to either increase reimbursement or decrease costs.
- List the ways discrepancies between submitted charges and paid charges are reconciled by the provider.
- What fraudulent acts can be identified in this process?
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