Fill in Order Details

  • Submit paper details for free using our simple order form

Make Payment Securely

  • Add funds to your account. There are no upfront payments. The writer will only be paid once you have approved your paper

Writing Process

  • The best qualified expert writer is assigned to work on your order
  • Your paper is written to standard and delivered as per your instructions

Download your paper

  • Download the completed paper from your online account or your email
  • You can request a plagiarism and quality report along with your paper

Reimbursement Methodology

Reimbursement Methodology

Order Description

1.IPPS: High cost devices are used in many inpatient surgery cases. The Safe-Cross®, radio frequency total occlusion crossing system, is such a device.

The Safe-Cross® guidewire is present on the following claim. Complete an outlier payment calculation to determine whether this claim would qualify for a high cost outlier payment. If the claim qualifies for outlier payment, calculate the total reimbursement for this claim, including the aIDitional amount that the facility would receive for the high cost outlier. Formulas are provided for you

2.IPPS: The top 25 MS-DRGs for Hospital A are provided in the table below. Calculate the case mix index for this MS-DRG set

Assignment #3

1.    IPPS: High cost devices are used in many inpatient surgery cases. The Safe-Cross®, radio     frequency total occlusion crossing system, is such a device.

The Safe-Cross® guidewire is present on the following claim. Complete an outlier payment calculation to determine whether this claim would qualify for a high cost outlier payment. If the claim qualifies for outlier payment, calculate the total reimbursement for this claim, including the aIDitional amount that the facility would receive for the high cost outlier. Formulas are provided for you

The 2013 IPPS high-cost outlier threshold is $21,821; the hospital specific CCR is: 0.329; the hospital base rate is $5,200.00.

Inpatient Claim

Admit Date:    January 12, 2013    Discharge Date:    January 10, 2013    Length of Stay:    9 days

Principal Diagnosis:    410.71     Subendocardial infarction, initial episode of care

Secondary Diagnosis:    414.01    Coronary atherosclerosis of native coronary artery

Secondary Diagnosis:    427.1    Paroxysmal ventricular tachycardia

Secondary Diagnosis:    272.0    Pure hypercholesterolemia

Principal Procedure:    00.66

Percutaneous transluminal coronary angioplasty

Secondary Procedure:    36.07    Insertion of drug-eluting coronary artery stent

Secondary Procedure:    39.29    Other vascular shunt or bypass

Secondary Procedure:    37.22    Left heart cardiac catheterization

MS-DRG: 246

RW: 3.1566    Percutaneous cardiovascular procedure with drug-eluting stent with major complication/comorbidity or 4+vessels/stents

Claim Detail

Revenue Code    Revenue Code Description    Charge

110    Room & board – private    $4,375.00

120    Room & board – semi private    $1,700.00

200    Intensive care – general    $2,910.00

206    Intensive care – intermediate ICU    $1,780.00

250    Pharmacy –  general    $1,486.66

255    Pharmacy – drugs incident to radiology    $728.13

258    Pharmacy – IV solutions    $1,583.60

259    Pharmacy – other pharmacy    $7,766.18

270    Medical/surgical supplies – general    $8,256.00

272    Medical/surgical supplies – sterile supply    $8,366.25

272    The Safe-Cross® guidewire    $12,000.00

278    Medical/surgical supplies – other implants    $28,623.00

301    Laboratory –chemistry    $2,739.00

302    Laboratory – Immunology    $648.00

305    Laboratory – Hematology    $2,335.00

323    Laboratory – Arteriography    $2,491.00

360    Operating room – general    $13,875.00

361    Operating room – minor surgery    $517.00

370    Anesthesia – general    $209.00

390    Blood and blood component admin, process, storage – gen    $668.00

410    Respiratory services – general    $21.00

420    Physical therapy – general    $314.00

430    Occupational therapy – general    $441.00

480    Cardiology – general    $5,629.00

481    Cardiology – cardiac cath lab    $6,249.00

483    Cardiology – echocardiology    $1,786.00

710    Recovery room – general    $1,648.00

730    EKG/ECG – general    $1,098.00

921    Other diagnostic services – peripheral vascular lab    $359.00

TOTAL CHARGE:    $120,601.80

Outlier = cost of claim > reimbursement of claim + threshold

Cost = charge * hospital specific cost to charge ratio

Claim reimbursement = MS-DRG relative weight * hospital base rate

HC outlier payment = 80% * (cost – (claim reimbursement + threshold))

TOTAL reimbursement for claim = claim reimbursement + HC outlier payment

2.    IPPS: The top 25 MS-DRGs for Hospital A are provided in the table below. Calculate the case mix index for this MS-DRG set.

MS-DRG    MS-DRG Title     Volume     MDC    TYPE    RW    Weighted Average

470    Major joint replacement or reattachment of lower extremity w/o MCC     420     08    SURG    2.0953

392    Esophagitis, gastroent & misc digest disorders w/o MCC     332     06    MED    0.7375

194    Simple pneumonia & pleurisy w CC     295     04    MED    0.9996

247    Perc cardiovasc proc w drug-eluting stent w/o MCC     280     05    SURG    1.9911

293    Heart failure & shock w/o CC/MCC     246     05    MED    0.6751

313    Chest pain     233     05    MED    0.5617

292    Heart failure & shock w CC     232     05    MED    1.0034

690    Kidney & urinary tract infections w/o MCC     219     11    MED    0.781

192    Chronic obstructive pulmonary disease w/o CC/MCC     218     04    MED    0.7072

871    Septicemia w/o MV 96+ hours w MCC     213     18    MED    1.8803

641    Nutritional & misc metabolic disorders w/o MCC     209     10    MED    0.692

291    Heart failure & shock w MCC     193     05    MED    1.5174

885    Psychoses     188     19    MED    0.9539

312    Syncope & collapse     177     05    MED    0.7339

287    Circulatory disorders except AMI, w card cath w/o MCC     173     05    MED    1.0709

195    Simple pneumonia & pleurisy w/o CC/MCC     172     04    MED    0.7078

310    Cardiac arrhythmia & conduction disorders w/o CC/MCC     171     05    MED    0.5541

603    Cellulitis w/o MCC     143     09    MED    0.8392

379    G.I. hemorrhage w/o CC/MCC     137     06    MED    0.7015

191    Chronic obstructive pulmonary disease w CC     131     04    MED    0.9521

065    Intracranial hemorrhage or cerebral infarction w CC     128     01    MED    1.1345

683    Renal failure w CC     116     11    MED    0.9958

189    Pulmonary edema & respiratory failure     114     04    MED    1.2461

069    Transient ischemia     110     01    MED    0.7449

066    Intracranial hemorrhage or cerebral infarction w/o CC/MCC     102     01    MED    0.8135

Totals

CMI                1.0682

PLACE THIS ORDER OR A SIMILAR ORDER WITH US TODAY AND GET AN AMAZING DISCOUNT :)

term papers to buy
research papers

WHAT OUR CURRENT CUSTOMERS SAY

  • Google Rating
  • Sitejabber
  • Trustpilot
Cindy L
Cindy L
You can't fault the paper quality and speed of delivery. I have been using these guys for the past 3 years and I not even once have they ever failed me. They deliver properly researched papers way ahead of time. Each time I think I have had the best their professional writers surprise me with even better quality work. Elite Academic Research is a true Gem among essay writing companies.
Samuel Y
Samuel Y
I really appreciate the work all your amazing writers do to ensure that my papers are always delivered on time and always of the highest quality. I was at a crossroads last semester and I almost dropped out of school because of the many issues that were bombarding but I am glad a friend referred me to you guys. You came up big for me and continue to do so. I just wish I knew about your services earlier.
Mindi D
Mindi D
Brilliant writers and awesome support team. You can tell by the depth of research and the quality of work delivered that the writers care deeply about delivering that perfect grade.
Stuart L
Stuart L
Thanks for keeping me sane for getting everything out of the way, I’ve been stuck working more than full time and balancing the rest but I’m glad you’ve been ensuring my school work is taken care of. I'll recommend Elite Academic Research to anyone who seeks quality academic help, thank you so much!
Zahraa S
Zahraa S
Absolutely spot on. I have had the best experience with Elite Academic Research and all my work have scored highly. Thank you for your professionalism and using expert writers with vast and outstanding knowledge in their fields. I highly recommend any day and time.

ORDER NOW

Consider Your Assignments Done

“All my friends and I are getting help from eliteacademicresearch. It’s every college student’s best kept secret!”

Jermaine Byrant
BSN

“I was apprehensive at first. But I must say it was a great experience and well worth the price. I got an A!”

Nicole Johnson
Finance & Economics

Our Top Experts

————-

See Why Our Clients Hire Us Again And Again!


OVER
10.3k
Reviews

RATING
4.89/5
Avg Rating

YEARS
12
Experience

Elite Academic Research Promises You:


Always on Time

If we are a minute late, the work is on us – it’s free!

Plagiarism-free

If the work we produce contains plagiarism we’ll pay out a £5,000 guarantee.

Quality

Providing quality work is core to our beliefs, which is why we will strive to give you exactly that, and more!

Written to Standard

All of our assignments go through a stringent quality checking process from start to finish.

Success Guarantee

When you order form the best, some of your greatest problems as a student are solved!

Reliable

Professional

Affordable

Quick

Short Answers To Common Questions

[ultimate-faqs]

YOUR EDUCATION ON AUTOPILOT

Pay an expert to take your online class and say goodbye to poor grades, missed deadlines, and the struggles
of balancing your education with other work/life responsibilities. Life Is too Short to Spend on Classes
You Have No Interest In. Focus on what is really important in your life. Let our professional handle your class.

    Guaranteed A or B

    100% Confidential

    Experienced Tutors

    24/7 Support

Fill in free quote request

Tell us about your online class and what help you need. Try to give us the maximum information.

Agree on price

Our representative will contact you to discuss the details of your order and the rates for our assistance.

Pay and get help

When everything is agreed, you will receive an email with the invoice. After you pay, we start working on your task.

error: Content is protected !!