CCH® Reimbursement ToolKit
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More Info: 1-888-CCH-REPS
The complete, one-stop shop for forecasting Medicare reimbursement.
Designed to assist health care reimbursement professionals with forecasting their Medicare reimbursement from CMS, the CCH Reimbursement ToolKit offers the ultimate cost-effective way to supplement or audit expensive contract management tools and
billing systems. It also provides an impressive, time-saving alternative to complex Microsoft Excel® spreadsheets. And, unlike free or inexpensive calculators available on the Web, CCH updates the information used by the calculators on a weekly basis, so you enjoy peace of mind knowing you’re using current data.
The CCH Reimbursement ToolKit provides seven separate calculators The calculators, accessed via the Internet, link directly to related laws, regulations and final rules, so you can examine the rationale behind the calculations. In addition, reports of each calculation are generated with the ability to save, print or e-mail. And, each calculator features a wider geographic location drop-down pick list to accommodate longer names. The ToolKit also provides 2004, 2005, 2006 and 2007 data—not just a single year.
Calculators
- Inpatient Prospective Payment System:
- The hospital-specific DRG payment rate for the beneficiary’s case
- Whether the case qualifies for an outlier payment, and, if it qualifies, what the outlier payment will be
- The ability to simply enter a Provider Number for faster and easier calculations
- Wage Index Data, which now includes blended wage values for superior accuracy
- Outpatient Prospective Payment System
(enhanced to calculate up to
100 codes at one time):
- The hospital-specific payment amount for each HCPCS and APC classification assigned to the beneficiary’s case
- Whether the case qualifies for an outlier payment, and, if it qualifies, what the outlier payment will be
- The ability to simply enter a Provider Number for faster and easier calculations
- Wage Index Data, which now includes blended wage values for superior accuracy
- Long-term Care Hospital Prospective Payment System:
- The LTCH specific LTC-DRG payment rate for the beneficiary’s case
- Whether the case qualifies for a high-cost outlier and/or short-stay outlier payment, and, if it qualifies, what the outlier payment will be
- Inpatient Rehabilitation Facility Prospective Payment System:
- The IRF specific payment rate for each case
- If the case qualifies for transfer per diem payment
- Whether the case qualifies for an outlier payment, and, if it qualifies, what the outlier payment will be
- Physician Fee Schedule
(enhanced to calculate up to 100 codes at
one time):
- The Medicare payment amount under the Physician Fee Schedule (80% of the lesser of the doctor’s actual charge
or fee schedule amount)
- A service’s eligibility for the Health
Professional Shortage Area Bonus
- For each calendar year, a service’s eligibility for the Physician Scarcity Area Bonus
- Skilled Nursing Facility Prospective Payment System Calculator:
- The SNF’s specific RUG payment rate for each beneficiary’s case
- Whether the case qualifies for an adjustment under either the Balanced Budget Refinement Act of 1999 (BBRA) or the Benefits Improvement and Protection Act of 2000 (BIPA)
- The payment for the RUG in which the beneficiary is classified if the beneficiary has a diagnosis of AIDS (diagnosis code 042) for services rendered on or after October 1, 2004
- Inpatient Psychatric Facility Prospective Payment System:
- Hospital-specific DRG payment rate for each case
- Whether the case qualifies for an outlier payment, and, if it qualifies, what the outlier payment will be
Where applicable, the calculators will also determine whether or not a case qualifies for outlier payment and determine that outlier payment rate. You can print, save or email reports generated by the calculators. In addition, laws, regulations and final rules on which the calculations are based are linked from the CCH Medicare and Medicaid Guide to the calculators.
Benefits and Features
- Easy to use. Simply enter your
Provider Number to obtain calculation results—no geographic classification
will be required. Additionally, the Wage Index Data now includes blended
wage values for superior accuracy.
- Faster results. Calculate up to 100 codes at a time!
- One Stop Shop containing calculators for seven Prospective Payment Systems
- The only calculator available for Inpatient Psychiatric Facilities
- Obtain precise reimbursement figures based on facility's cost report
- Link to applicable laws, regulations and final rules to ensure compliance
- Generate reports, including executive summary reports or detailed reports containing formulas
- Print, Save or Email reports
- Always up to date
Specifications
- Internet: Updates as needed.
