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Bundled Payments for Care Improvement Application Guidance Webinar April 19, 2012, Bundled Payments for Care Improvement Speakers Sheila Hanley, MPH, MA, Rachel Homer, Else Peeler, MPH Bundled Payments

How to fill out bundled payments for care

How to fill out bundled payments for care:

1. Understand the concept of bundled payments: Familiarize yourself with the idea that bundled payments involve a single payment for all services related to a specific episode of care. This includes all healthcare providers involved in the patient's treatment and recovery.
2. Determine the bundled payment model: Identify the specific bundled payment model you are working with, as there are various types such as retrospective, prospective, and concurrent. Each model has different requirements and timelines for submitting payment information.
3. Gather relevant documentation: Collect all necessary documentation related to the episode of care, such as medical records, itemized bills, and any other required documentation specified by the bundled payment program or payer. Ensure that the documentation is accurate and complete.
4. Identify the correct billing codes: Assign the appropriate billing codes to each service provided during the episode of care. This ensures accurate reimbursement and prevents any billing errors. Adhere to the coding guidelines provided by the payer or bundled payment program.
5. Calculate the bundled payment amount: Determine the bundled payment amount based on the agreement with the payer or bundled payment program. This may involve calculating the total cost of care, factoring in any applicable discounts or penalties, or using a predetermined reimbursement rate.
6. Submit the bundled payment information: Once you have gathered all required documentation, input the necessary information into the designated billing system or software. Ensure that you submit the information within the specified timelines to prevent any delays or payment denials.
7. Monitor payment status and follow-up: Keep track of the payment status for each bundled payment submission. Follow up with the payer or bundled payment program if there are any delays or issues in receiving payment. Address any inquiries or concerns promptly to ensure timely reimbursement.

Who needs bundled payments for care?

1. Healthcare providers: Providers who participate in bundled payment programs can benefit from a more streamlined payment process, as well as the potential for improved care coordination and resource management. It can also incentivize providers to deliver high-quality and cost-effective care.
2. Payers: Payers, such as insurance companies or government agencies, may implement bundled payment models to control costs, encourage collaboration among providers, and promote better patient outcomes. Bundled payments can help align financial incentives and improve the overall value of healthcare services.
3. Patients: Bundled payments can also benefit patients by promoting coordinated care, reducing unnecessary healthcare utilization, and potentially lowering out-of-pocket expenses. Patients may experience better care transitions and improved outcomes with a focus on value-based, patient-centered care delivery.

In conclusion, understanding how to fill out bundled payments for care involves familiarizing yourself with the concept, gathering documentation, assigning proper billing codes, calculating payment amounts, and submitting information timely. Various stakeholders, including healthcare providers, payers, and patients, can benefit from bundled payment models.

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What is bundled payments for care?

Bundled payments for care involves making a single payment for a set of services related to a specific medical condition or procedure.

Who is required to file bundled payments for care?

Healthcare providers or facilities participating in bundled payment programs are required to file bundled payments for care.

How to fill out bundled payments for care?

Bundled payments for care are typically filled out using specific billing codes and documentation related to the services provided.

What is the purpose of bundled payments for care?

The purpose of bundled payments for care is to incentivize healthcare providers to deliver high quality and cost-effective care for a specific medical episode.

What information must be reported on bundled payments for care?

Information such as patient demographics, services provided, costs, and outcomes must be reported on bundled payments for care.