Description
Book SynopsisThe fourth book in the Healthcare Payment System series, Cost-Based, Charge-Based, and Contractual Payment Systems compares cost-based systems, charge-based payment approaches, and contractually-based payment processes with fee-schedule 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 cost-based, charge-based, 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 cost-based 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:
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Table of Contents
Introduction. Healthcare Provider Costs and Cost-Based Payment Systems. healthcare Provider Charges and Charge-Based Payment Systems. Contractual Payment Systems. Capitated Payment Systems. Claim Adjudication and Compliance. Summary, Conclusion, and the Future. List of Acronyms. Appendices: Synopsis of the Medicare Program’s Payment Systems. Case Study List.
