Hasil Pencarian  ::  Simpan CSV :: Kembali

""Understanding Health Insurance, Twelfth Edition, is the essential learning tool you need when preparing for a career in medical insurance billing. This comprehensive and easy-to-understand text is fully updated with the latest code sets and guidelines, and covers important topics in the field like managed care, legal and regulatory issues, coding systems, reimbursement methods, medical necessity, and common health insurance plans. The Twelfth Edition has been updated to include new legislation that affects health care, ICD-10-CM coding, implementing the electronic health record, the Medical Integrity Program (MIP), the medical review process, and more. Practice exercises in each chapter provide plenty of review, and the accompanying workbook provides even more application-based assignments and additional case studies for reinforcement,. Purchase of this text includes access to free online SimClaim CMS-1500 claims completion software and free-trial access to Optum?s EncoderPro.com - Expert encoder software" -- p. [4] of cover."

"Extremely practical and packed with current examples, this title delivers a comprehensive overview of the business side of healthcare. It offers detailed discussions of cost reimbursement programs, economic factors driving the cost of medical services, and healthcare reform. "

"Tujuan: Penelitian ini dilakukan untuk mengetahui gambaran biaya produk radioterapi eksterna dan tarif reimbursement berdasarkan Jaminan Kesehatan Nasional (JKN) di Indonesia serta mengetahui kesesuaian antara keduanya. Metodologi: Desain penelitian ini menggunakan metode potong lintang dan pengumpulan data dilakukan dengan total sampling. Data yang terkumpul kemudian dihitung menjadi tiga model perhitungan biaya produk aktual, optimal dan sesuai RRCC versi 20 dari IAEA selanjutnya dibandingkan kesesuaiannya dengan tarif reimbursement JKN. Hasil: Pengumpulan data akhir didapatkan 29 senter partisipan yang dapat diolah datanya dari 19 senter dari RS pemerintah dan 10 RS swasta namun tidak semua senter mengumpulan data dengan lengkap, hanya 5 senter yang mengumpulkan data hingga data amortisasi dan pemeliharaan peralatan dengan lengkap. Senter pemerintah melayani 340.265 fraksi dalam setahun sedangkan swasta 99.547 fraksi. Median biaya produk aktual pada lima senter lengkap, biaya produk optimal dan sesuai RRCC berturut-turut Rp 1.253.552, Rp 1.787.606 dan Rp 1.520.066. Biaya produk aktual dan optimal berdasarkan level PORI (sesuai teknik) berbeda bermakna secara statistik antara level 1A dan 2 atau 3 secara berturut-turut p= 0.014 dan p< 0.001, berdasarkan jenis pesawat Cobalt dibanding Linac biaya produk aktual (p= 0.002), optimal (p= 0.001) dan RRCC (p= 0.022), berdasarkan klasifikasi jumlah fraksi rendah dibanding sedang atau tinggi per tahun biaya produk aktual (p= 0.013) dan RRCC (p= 0.015). Kesimpulan: Secara garis besar gambaran biaya produk dipengaruhi oleh teknik radiasi, jenis pesawat, jumlah fraksi. Perhitungan biaya produk yang direkomendasikan sebagai acuan tarif adalah biaya produk optimal karena sudah memperhitungkan kapasitas dan kemampuan senter untuk berkembang. Tarif JKN menunjukkan tren yang lebih rendah jika dibandingkan dengan biaya produk optimal, sedangkan jika dibandingkan dengan biaya produk aktual tampak tren lebih tinggi dibanding biaya produk yang dihasilkan dengan hanya 5 senter yang memiliki data lengkap.

---

Aims: The aim of this study was to describe the external beam radiation therapy cost and reimbursement tariff based on National Health Insurance (NHI) in Indonesia and to ascertain whether the two were compatible. Methodology: The design of this study used a cross-sectional method and total sampling was used for data collection. The three models created using the collected data to estimating actual, optimal and product cost according to RRCC version 20 from IAEA then assessed for appropriateness against the NHI reimbursement. Results: The final data collection revealed that 29 participating centers came from 10 private hospitals and 19 public hospitals, although not all centers collected complete data, only 5 centers collected data up to complete amortization data and maintenance. In a year, public hospital centers serve 340.265 fractions while private centers serve 99.547 fractions. The median actual product cost for 5 complete centers, optimal product cost and according to RRCC product cost were IDR 1,253,552, IDR 1,787,606, and IDR 1,520,066. According to the radiation technique, level 1A and 2 or 3 of the actual and optimal product costs differed statistically significant (p = 0.014 and p 0.001, respectively), while Cobalt compared to Linac actual product costs (p = 0.002), optimal product cost (p = 0.001) and RRCC (p = 0.022), based on the classification of the number of fractions low compared to medium or high per year actual product cost (p= 0.013) and RRCC (p= 0.015). Conclusion: Radiation technique, machine type and fractionation count all have a general impact on product cost. The optimal product cost calculation suggested as a tariff reference, because it has taken into account the capacity and ability of the centers to develop. The reimbursement shows a lower trend when compared to the optimal product cost, whereas when compared to the actual product cost, it appears to be a higher trend with only 5 centers having complete data."