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February 10, 2023

Explain the different types of general reimbursement methodologies below, describe how the provider is reimbursed under each of the methods and what, if any, the provider can do to

1. Explain the different types of general reimbursement methodologies below, describe how the provider is reimbursed under each of the methods and what, if any, the provider can do to maximize reimbursement.
Fee for service methods:
a. Cost based reimbursement
b. Charge based reimbursement
c. Prospective payment
– Per procedure
– Per diagnosis
– Per Diem
– Bundled Payment
2. What is the primary difference between fee-for-service reimbursement and capitation? What is the key to profitability for the capitation reimbursement method?
3. Describe how Medicare pays for inpatient services.
Please answer in English and please provide references used
Thank you

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