HINT 250 – Representative selections from different aspects of healthcare reimbursement

Representative selections from different aspects of healthcare reimbursement will be compiled into a project demonstrating the student’s understanding of health information management concepts required to manage healthcare reimbursement.Questions:Outline the differences between facility (hospital) claims processing and professional (provider) claims processing. What is the difference? What claims are usedComparison of major healthcare payment and reimbursement systems found in the U.S. And one other country (of the student’s choice).Outline of the different prospective payment systems (PPS) currently in use in the United States, including a description of the type of diagnostic and procedural groupings used in each PPS (not each individual grouping within each PPS; for example, we are not looking for a description of each DRG but a description of DRGs in general). Provide an example of each PPS, what they are and why they are used in the U.S.Report on the history of Local Coverage Decisions (or LCDs). Provide one current (within the past 12 months) examples of an LCD currently active in your regional Medicare intermediary. Explain how each of these LCDs is used in the payment practice.