Utilization review within PPS.
Requisite to managing the cost of treating medicare patients is a utilization review process that will decrease hospital risk under PPS. This review process is explained as well as the reimbursement schedules for hospital resource/cost or day outliers.
D011366:Professional Review Organizations; D011445:Prospective Payment System; D012051:Reimbursement Mechanisms; D014481:United States; D014600:Utilization Review