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What is IPPS (inpatient prospective payment system) for Medicare?
The purpose of the post is to briefly explain how to calculate operating and capital DRG (diagnosis related groups) payments. What are DRGs (Diagnosis Related Groups)? “Under the IPPS, each case is...
View ArticleReconcilition of Outlier Payments: How the Cost-to-Charge Ratio (CCR) Matters
In this post, I’d like to explain what happens when your final settled CCR is different from your priced CCR. I discussed before in the outlier discussion that the ratio of cost-to-charge (RCC or CCR)...
View ArticleMedicare Charges: What does CMS have to offer?
Interestingly, CMS has recently published charges for more than 3,000 hospitals paid under IPPS. The charges include the top 100 most frequently billed charges during Fiscal Year 2011. CMS says that...
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