- 06 Apr, 2021
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S4 Paying for Hospital and Physician Services
Using the references below, as well as some additional research in peer-reviewed sources, complete your SLP assignment by answering the following:
1. What are the specific reimbursement methods used by each of the major third-party payers?
2. What are the specific incentives and the risks for the providers under the various payment types?
3. What are the differences between insurance-negotiated rates and the private pay fees charged to uninsured patients for health care services? Is there a difference, and if so, how much is it? Provide an example of what is charged for one specific service (appointment, test, etc.).
References
Centers for Medicare and Medicaid Services (2019). Acute care hospital inpatient prospective payment system. Available at: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/AcutePaymtSysfctsht.pdf
Centers for Medicare and Medicaid Services (2019). Hospital outpatient prospective payment system. Available at: https://www.cms.gov/Outreach-and-