Question

The subject is: Introduction to Healthcare Insurance Coding, Billing, and Reimbursement

Can you provide examples of a charge for the following: ambulance fee schedule, ambulatory surgical center payment, clinical laboratory fee schedule, durable medical equipment prosthetics orthotics and supplies fee schedule, end-stage renal disease composite payment rate system, home health prospective payment system, hospital inpatient prospective payment system, hospital outpatient prospective payment system, inpatient psychiatric facility prospective payment system, inpatient rehabilitation facility prospective payment system, long term acute care hospital prospective payment system, resource based relative value scale system, and skilled nursing facility prospective payment system.

Answer 1

In medical billing, coding and reimbursement firstly, we need to do the coding starting from the patient's admission till he discharges from the hospital set up.

For example:

Lets suppose Patient A has entered the hospital, so starting from the admission process we need to calculate the charges.

Lets say:

Ambulance fee schedule- $100

Ambulatory surgical center payment- $300

Clinical laboratory fee schedule- $200

Durable medical equipment prosthetics orthotics and supplies fee schedule- $500

End-stage renal disease composite payment rate system- $700

Home health prospective payment system- $600

Hospital inpatient prospective payment system- $400

Hospital outpatient prospective payment system- $350

Inpatient psychiatric facility prospective payment system- $300

Inpatient rehabilitation facility prospective payment system- $250

Long term acute care hospital prospective payment system- $500

Resource based relative value scale system- $300

Skilled Nursing Facility prospective payment system- $300