Prospective Payment Systems
Language: English
Published by Productivity Press, 2012
- Softcover
- Used
Seller: World of Books Inc, Montgomery, IL, U.S.A.World of Books Inc
AbeBooks seller since March 23, 2026
Condition: Used - Good
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Add to basketItem description from seller
The third book in the Healthcare Payment Systems series, Prospective Payment Systems examines the various types of prospective payment systems (PPS) used by healthcare providers and third-party payers. Emphasizing the basic elements of PPS, it considers the many variations of payment for hospital inpatient and outpatient services, skilled nursing facilities, home health agencies, long-term hospital care, and rehabilitation facilities along with other providers. The book describes the anatomy of PPS, including cost reports, adjudication features and processes, relative weights, and payment processes. It outlines the features and documentation requirements for Medicare Severity Diagnosis Related Groups (MS-DRGs), the Medicare Ambulatory Payment Classifications (APCs), Medicare HHPPS, Medicare Skilled Nursing Resource Utilization Groups (RUGs), and private third-party payers. Provides a framework for understanding and analyzing the characteristics of any PPSDiscusses Medicare prospective payment systems and approachesIncludes specific references to helpful resources, both online and in printFacilitates a clear understanding of the complexities related to PPS?covering specific topics at a high level and revisiting similar topics to reinforce understandingComplete with a detailed listing of the acronyms most-commonly used in healthcare coding, billing, and reimbursement, the book includes a series of case studies that illustrate key concepts. It concludes with a discussion of the challenges with PPS?including compliance and overpayment issues?to provide you with the real-world understanding needed to make sense of any PPS.…
Seller Inventory # CIN1439873011G
- Title
- Prospective Payment Systems
- Author
- Duane C Abbey
- Publisher
- Productivity Press
- Publication year
- 2012
- Condition
- Good
- Binding
- Paperback
- Language
- English
- ISBN 10
- 1439873011
- ISBN 13
- 9781439873014
The third book in the Healthcare Payment Systems series, Prospective Payment Systems examines the various types of prospective payment systems (PPS) used by healthcare providers and third-party payers. Emphasizing the basic elements of PPS, it considers the many variations of payment for hospital inpatient and outpatient services, skilled nursing facilities, home health agencies, long-term hospital care, and rehabilitation facilities along with other providers.
The book describes the anatomy of PPS, including cost reports, adjudication features and processes, relative weights, and payment processes. It outlines the features and documentation requirements for Medicare Severity Diagnosis Related Groups (MS-DRGs), the Medicare Ambulatory Payment Classifications (APCs), Medicare HHPPS, Medicare Skilled Nursing Resource Utilization Groups (RUGs), and private third-party payers.
- Provides a framework for understanding and analyzing the characteristics of any PPS
- Discusses Medicare prospective payment systems and approaches
- Includes specific references to helpful resources, both online and in print
- Facilitates a clear understanding of the complexities related to PPS―covering specific topics at a high level and revisiting similar topics to reinforce understanding
Complete with a detailed listing of the acronyms most-commonly used in healthcare coding, billing, and reimbursement, the book includes a series of case studies that illustrate key concepts. It concludes with a discussion of the challenges with PPS―including compliance and overpayment issues―to provide you with the real-world understanding needed to make sense of any PPS.
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