Case Assignment
\nPart I – Paying for Hospital Services – Overview
\nMr. Scott is a 69-year-old hospitalized for a Permanent Cardiac Pacemaker procedure. Hillcrest Hospital is a large urban hospital in Cleveland that incurred $275,000 in Medicare-approved charges for treating Mr. Scott. Use the information provided in this module as well as the Hospital Payments Example, found in the Course Table of Contents under the Presentation section, to answer the Case 4 assignment questions. Include all formulas and calculations in your paper.
\nDRG\tDescription\tCase Weight
\n115\tPermanent Cardiac Pacemaker\t3.5513
\n302\tKidney Transplant\t4.1370
\n441\tHand Procedure\/Surgery\t0.8785
\nPart I – Assignment
\nAnswer (in about 3 pages) the following questions for Kidney Transplant only:
\n1.\tWhat is the operating payment to be paid to the hospital?
\n2.\tWhat is the capital payment to be paid to the hospital?
\n3.\tWill the hospital be eligible for the Medicare outlier payment?
\n4.\tWhat is the total payment to the hospital?
\nPart II – Paying for Physician Services – Overview
\nMr. Roberts is a 66-year-old Medicare beneficiary. He sought treatments from Dr. Robinson. Assume the following values for the services provided by Dr. Robinson:
\nCategories\tRVU\tGeographic Cost Index\tProduct
\nWork\t24.35\t1.092\t29.98
\nPractice Expense\t37.08\t1.743\t75.04
\nMalpractice\t15.69\t0.543\t5.60
\nConversion Factor: 64.43
\nPart II \u2013 Assignment
\nPlease answer in about 3 pages the following questions:
\n1.\tHow much will Medicare pay Dr. Robinson if Dr. Robinson is a Medicare participating physician? How much out-of-pocket payment will Mr. Roberts be responsible for?
\n2.\tHow much will Medicare pay Dr. Robinson if Dr. Robinson is a Medicare non-participating physician who elects assignment? How much out-of-pocket payment will Mr. Roberts be responsible for?
\n3.\tHow much will Medicare pay Dr. Robinson if Dr. Robinson is a Medicare non-participating physician who does not elect assignment? How much out-of-pocket payment will Mr. Roberts be responsible for?
\nAssignment Expectations
\nLength: The paper should be typed and double spaced, using 12 pt. Times New Roman font and 1-inch page margins. Use headers throughout the paper. This will aid you in not overlooking vital elements of the assignment and make the document easier for the reader to follow.<\/p>\n","protected":false},"excerpt":{"rendered":"
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