Developing Charges and Hospital Pricing

Event Information
Product Format
Prerecorded Event
60 Minutes
Product Description

Pick apart your payment system so that you’re not missing precious payments.

These days, you can’t escape controversy over hospital charges and pricing — especially as hospital prices have become inflated.

Go in-depth behind the curtain of hospital pricing. Define what device-dependent APCs and DRGs are. Learn what the fuss is about “charge compression.” Here’s how you can control our cost-to-charge ratios and price devices, supplies, drugs, and biologicals. Plus, you can miss charges in connection with supplies and pharmacy items — find out this is what you’re doing.

Don’t fall into the trap of hospital charges. Here’s how you can adjust your pricing and address charge compression. Learn how this will affect APC and DRG reimbursement. Finally, your pricing structure can impact the cost report. Here’s what to do about it.

This session will help you:

  • Learn why hospital charges and pricing are in the spotlight
  • Understand why charges are important for APCs and DRGs
  • Define the cost report and cost-to-charge ratios (CCRs)
  • Demystify the concept of ‘charge compression’
  • Take advantage of these special charge development techniques
  • Highlight when charges may be inappropriate
  • Recognize when full charges are not being reported
  • Appreciate how charges and pricing impact on the cost report
  • Review action steps to adjust pricing

Teleconference Agenda: 

  • Overview of Developing Chargemaster Pricing and Charges
    • The Need For Change
    • Charge Formulas and Mark-Up Formulas
    • Strategies for Adjusting Pricing
  • Types of Payment Systems and Use of Charge Data
    • APCs
    • DRGs
    • Cost Based Payments
  • Charge-Compression, Cost-to-Charge Ratios and the Cost Report
    • Tiered Pricing for Supplies and Drugs
    • Charge Compression and Cost-to-Charge Ratios
    • Cost Reporting Issues
    • RTI International Recommendations
    • Medicare Changes to the Cost Report for Devices
  • CMS Use of Charges to Determine Weights
    • Converting Charges to Costs
    • APCs
    • MS-DRGs – Charge-Based vs. Cost-Based
  • Pricing and Charge Formulas
    • Overall Charge Philosophy
    • Bundling versus Separately Charging
    • Proper Charging Even Though No Separate Payment
  • Cost Report Impact Through Charges and Pricing Structures
  • Chargemaster Coordinator Action Steps

Who should attend? Chargemaster Coordinators, Billing and Claims Generation Personnel, Compliance Personnel, Patient Financial Management Personnel, Cost Accounting Personnel, Cost Report Personnel, Financial Analysts, Managed Care Contract Personnel, Revenue Enhancement Personnel, Chief Financial Officers, Chief Compliance Officers, Financial Planners, Reimbursement Specialists, All Other Hospital Personnel Interested in Pricing

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About Our Speaker

Duane Abbey Hospital Coding & Compliance Expert

 Duane C. Abbey, Ph.D. is a management consultant and president of Abbey & Abbey, Consultants, Inc., which specializes in healthcare consulting and related areas. Duane earned his graduate degrees at the University of Notre Dame and Iowa State University and has more than 20 years of experience as a consultant. He performs various types of financial analysis involving business structuring, organizational development, enrolment and other financially related concerns of organizations....   More Info
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