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PRINTED: 08/30/2023 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION

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How to fill out hospital outpatient prospective payment

01

Gather all necessary information regarding the services provided during the hospital outpatient visit.

02

Refer to the hospital outpatient prospective payment system guidelines for the specific codes and rates for the services rendered.

03

Submit the completed claim form with all required documentation to the appropriate payer for reimbursement.

Who needs hospital outpatient prospective payment?

01

Hospitals and healthcare facilities that are billing for outpatient services and wish to receive reimbursement based on the hospital outpatient prospective payment system.

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What is hospital outpatient prospective payment?

Hospital outpatient prospective payment refers to a system where hospitals are paid a set amount for outpatient services based on the type and intensity of the services provided.

Who is required to file hospital outpatient prospective payment?

Hospitals that provide outpatient services are required to file hospital outpatient prospective payment.

How to fill out hospital outpatient prospective payment?

Hospital outpatient prospective payment is filled out by submitting the necessary data and information on outpatient services provided by the hospital.

What is the purpose of hospital outpatient prospective payment?

The purpose of hospital outpatient prospective payment is to standardize reimbursement for outpatient services and promote efficiency in healthcare delivery.

What information must be reported on hospital outpatient prospective payment?

Information such as the type of services provided, the cost of services, and the number of patients seen must be reported on hospital outpatient prospective payment.

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