Interested in learning more about outpatient outlier payments?
While the issues of inpatient cost-to-charge ratios have been discussed at length, what do you do in the case of APC-based payments? I found a nice description here: http://corporate.findlaw.com/law-library/hospitals-have-you-checked-your-potential-outlier-payments-under.html.
The basic premise is to calculate the excess costs above the threshold (by applying the hospital’s RCC) , which is 2.5 times the APC payments. Feel free to leave a comment if you would like a more through explanation about how this may affect the Medicare cost report.