How does the Quest Precision Pricing Software increase the hospital’s net revenue?
By unique / electronic modification of the pricing logic as the final billing step. For inpatient billing: the CDM charges are modified by Quest’s hospital-specific “severity-of – illness index” based on the DRG, generating the patient’s bill. For outpatient billing: the CDM charges are modified by Quest’s hospital-specific “site of service delivery-index” based on the revenue code, generating the patient’s bill. In-patient indexing logic is different from outpatient indexing logic. Both uniformly price all services to all patients regardless of payer. Quest models itself after the CMS “relative weight” format introduced by CMS in 1986, but allows the hospital the advantage of applying the modifiers to ALL PATIENTS in ALL SETTINGS. Both are historically proven to be both accurate, ethical, and CMS “Provider Reimbursement Review Board (PRRB) decisions support the practice”. Quest has been examined for 17 years in annual CMS cost reports and independent CPA firm audits receiving “unquali
Related Questions
- If the hospital is doing a good job regulating the Chargemaster, how does the hospital benefit from using the Quest Precision Pricing Software?
- How will the Quest software increase or decrease standard reimbursement from Medicare / Medicaid, or any other fixed-amount payer?
- How does the Quest Precision Pricing Software increase the hospitals net revenue?
