Wiki scheduling patients on different days due to OPPS APC packaging

thomas7331

Guest
Messages
5,029
Location
New Hartford, CT
Best answers
17
Has anyone else working in outpatient facilities come across this, or can anyone provide me some input on the compliance implications of scheduling patients for procedures/tests on separate days to get around the OPPS payment rules that package certain services together for payment? For example, if a patient has labs and x-rays done on the same day, the lab payment will usually package into the APC rate for the x-ray but if they are done on a different date, there will be a separate payment. My feeling is that this practice may create cash-flow for the facility up front but ultimately will result in reduced payments down the road when the next year's APCs are calculated, but I'm concerned about whether or not this is a compliant practice. I'd appreciate any feedback or resources than anyone might have about this.
 
Top