Mrs. Smith is a 70-year-old hospitalized for a Kidney Transplant procedure. General Hospital is a large urban hospital in San Francisco that incurred $150,000 in Medicare-approved charges in treating Mrs. Smith. Use the information provided in this module as well as the Hospital Payments Example, which can be found in the Module 4 Presentation section, to answer the following questions. Include all formulas and calculations in your paper.
|
DRG
|
Description
|
Case Weight
|
|
115
|
Permanent Cardiac Pacemaker
|
3.5513
|
|
302
|
Kidney Transplant
|
4.1370
|
|
441
|
Hand Procedure/Surgery
|
0.8785
|
Case Assignment
Answer the following questions for Kidney Transplant only:
- What is the operating payment to be paid to the hospital?
- What is the capital payment to be paid to the hospital?
- Will the hospital be eligible for the Medicare outlier payment?
- What is the total payment to the hospital?