Medicare FFS
Reimbursement Methods & Values
Hospital Inpatient
Hospital Outpatient
Product Admin. Length of Stay (days)
Product (Other Drugs) Reimbursement Method
Average Sales Price
PRODUCT A
PRODUCT B
Non-Product Reimbursement Method
% of Cost
%
Patient Out of Pocket Inputs
Hospital Inpatient
Hospital Outpatient
Patient Deductible Met (A & B)
Patient Deductible
Patient Co-Insurance
%
Secondary Insurance Status
Secondary Insurance (%)
%
%
Medicare Advantage
Reimbursement Methods & Values
Hospital Inpatient
Hospital Outpatient
Reimbursement Method
Product
Non-Product Drugs
Non-Product Drugs Plus X%
%
Non-Product Reimbursement Method
Adjusted MS-DRG (Commercial : Medicare Reimbursement Ratio)
% of Billed Charges
%
Case Rate Features
Case Rate Carve Out
Case Rate Amount
Case Rate Carve Out Reimbursement (ASP + X%)
Case Rate Time Period
Patient Out of Pocket Inputs
Hospital Inpatient
Hospital Outpatient
Patient Deductible Met
Patient Deductible
Patient Co-Insurance
%
Out of Pocket Max
Commercial
Reimbursement Methods & Values
Hospital Inpatient
Hospital Outpatient
Reimbursement Method
Product
Non-Product Drugs
Non-Product Drugs Plus X%
%
Non-Product Services
Adjusted MS-DRG (Commercial : Medicare Reimbursement Ratio)
% of Billed Charges
Case Rate Features
Case Rate Carve Out
Case Rate Amount
Case Rate Carve Out Reimbursement (ASP + X%)
Case Rate Time Period
Patient Out of Pocket Inputs
Hospital Inpatient
Hospital Outpatient
Patient Deductible Met
Patient Deductible
Patient Co-insurance
%
Out of Pocket Max