n a 2-3 page paper following APA format discuss how you would approach a negotiation between an insurance company and a hospital. You can choose to write from the insurance company or the hospital perspective. Describe a contract structure that you would use to negotiate and the reasons why you would use that structure. Summarize the financial implications of this reimbursement structure and it works in your organizations best interest.
I. Start by Choosing your preferred Unit of Payment and How Much You Want to Be Paid:
Payment systems can be categorized by 2 dimensions
a. Payment Basis
b. Unit of Payment
The basis of payment defines how the actual payment will be made. There are 3 primary methods-
1. Cost (where you are reimbursed for what you spent plus a percentage- AKA Cost Plus Reimbursement)
2. Fee Schedules – MOST COMMON (like Medicare or you can make your own. You can also do a % of Medicare such as 150 or 200%).
– e.g. DRG’s, APC’s, which are codes on
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