AmazingHealth

Medicare severity-diagnosis-related groups, abbreviated as MS-DRGs, are categories of inpatient hospital stays. The Medicare system uses them to determine reimbursements for hospitals, skilled nursing facilities, and hospices. A hospital stay can range from one day to 100 days. The most expensive MS-DRGs have the longest average stays. These expensive hospital services may include open-heart surgery or lung … Read more

If you’ve never heard of ancillary services before, you’re in the right place. Learn what these are and why you should care today.

In recent years, healthcare delivery systems have been focused on providing patients as much freedom of choice when it comes to their personal healthcare. These common types also allow for efficiency, lowered costs, and ease of use. 1. Telemedicine Although telemedicine existed before the COVID-19 pandemic, it has seen monumental growth in recent years. A … Read more

PPS stands for “prospective payment system” and is a classification system used by the Centers for Medicare and Medicaid Services (CMS). CMS is the government agency responsible for running both Medicare and Medicaid. A PPS is a method of reimbursement in which CMS payments to healthcare providers are made using a predetermined, fixed amount based on … Read more

To know what an ambulatory care pharmacy is, we first need to know what ambulatory care is. Ambulatory care or ambulatory treatment is another word for any outpatient care. This is any medical care that happens outside of a hospital. According to the Agency for Healthcare Research and Quality, “these settings include medical offices and clinics, … Read more

The ultimate guide to navigating what can be a confusing topic in healthcare. Although it can sound daunting, almost everyone will have to work with a third-party payer when navigating healthcare costs. You’ve likely dealt with one without even realizing a third-party payment (TPP) is what it’s called. Third-Party Payment Definition In the healthcare world, … Read more

A healthcare surrogate is someone who is legally responsible for making healthcare decisions for another person when they cannot make decisions for themselves. Healthcare surrogates, also called healthcare proxies, can be either legally designated or entitled to be a healthcare surrogate because of their relationship to the patient. Most people wanting to learn more about healthcare surrogates … Read more

Have you heard the term ‘FACETS’ in a healthcare setting and wondered what it is? FACETS is a core administration solution for health plans, developed by TriZetto®. It automates common healthcare administrative tasks, including claims processing, billing, care management, and network management workflow. FACETS was born out of the necessity for a solution that allowed … Read more

When registering for health coverage on Healthcare.gov, the Marketplace may ask you to upload some documents for verification purposes. These verification documents may include: estimate of yearly income, citizenship, immigration status, adoption and other issues. You’ll notice that the portal includes a list of acceptable documents to fulfill their requirements. You’ll need to gather these … Read more