Commercial/managed care

You are being asked to complete task 3 on pages 195. When calculating the reimbursement for CPT 73722 (MRI of the knee) and MS-DRG 470 (major joint
replacement) make you follow the the IPPS and OPPS formulas and indices information as covered in Module 3: Reimbursement Methods. Ignore the
reimbursement for CPT 73722 provided on page 200; recompute this reimbursement per Module 3. Note that this health system is located Milwaukee,
Wisconsin. Now assume assume that MRHS’s payer mix is 46 percent Medicare, 34 percent commercial/managed care, 16 percent Medicaid, and 4 percent
self-pay/no insurance. Calculate the average expected payment for each of the two procedures. What is your conclusion about the contractual allowance for
these two procedures?

find the cost of your paper

This question has been answered.

Get Answer