Question

lease fill the following tables for the postacute care prospective payment systems:

	SNFPPS Payment Process	LTCHPPS Payment Process	IRFPPS Payment Process	HHPPS Payment Process
Type of code used to determine the payment and the process by which the code is arrived at (write a few sentences for the process)
Patient data that must be presented with the claim
Facility level adjustments
Patient level adjustments
Outlier payment processes, if applicable (write a few sentences for the process)
Other adjustments, if any

Answer 1

Skilled nursing facility prospective payment system:

Type of code used to determine the payment and the process 4432 balanced budget act of 1997 how payment is made for Medicare skilled nursing facility services..SNFs not paid under reasonable cost basis to determine rates ,but on the prospective payment system (PPS)..payment rates for case mix and variations in wages and cover all costs in SNF services..

Patient data with clinical condition residents assessment process,estimate of the cost of service etc..

Facilities are no longer paid on a reasonable cost basis..Federal rates are set using cost of service SNF residents during a part A covered stay..providers receive exemptions in FY are excluded from the data base..Medicare beneficiaries are paid under part A of the Medicare benefts..

Patient coverage criteria includes SNF 30days of discharge from the three-day stay..on a daily basis,seven days a week by inpatient basis..