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Chapter 7 Reimbursement

Teacher: Nanci Cross
Horizontales
Service in which providers observed and monitor a patient to decide whether the patient needs to be admitted to IP care or discharged
Provider defined by statute who is eligible to participate in the Medicare Physician Quality Reporting Initiative. Services must be paid under the Medicare physician fee schedule
Previously referred to as fiscal intermediary
Short term care provided during the day or overnight to individuals in the home or institution to temporarily relieve the family home caregiver
Verticales
Entity that has a contract with CMS to determine and make Medicare payments for Part B benefits
Area designated by the federal Health Resources and Services Administration as having the following characteristics: too few PCPs, high infant mortality, high poverty, high elderly population
Care aimed at comfort
Lump sum payment
Provides palliative care
Unit of measure designed to permit comparison of the amount of resources required to perform various provider services by assigning weights to such factors as personnel time
Hospitalization program of intensive psycholotherapy that is provided in a day outpatient setting and is designated to keep patients with severe mental conditions from being hospitalized in an inpatient unit