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Author Question: What are the three major types of data collected by an MCO?[br][br][b][color=#FBB117]Question ... (Read 11 times)

imanialler

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on: Jul 12, 2018
What are the three major types of data collected by an MCO?

Question 2

Explain the concept of a diagnosis grouper.


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skipfourms123

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Reply #1 on: Jul 12, 2018
Answer to Question 1

Encounter Data, Referral Data, Claims Data

Answer to Question 2

A diagnosis grouper is a software program that predicts the amount of revenue the organization will receive for a patient's stay in the facility. The grouper requires the ICD diagnosis and procedure codes to be entered to calculate the reimbursement to the facility. The inpatient facility receives a set payment regardless of the number of days the patient is hospitalized.


imanialler

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Reply #2 on: Jul 12, 2018
Thank you :)


skipfourms123

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Reply #3 on: Jul 12, 2018
Happy to help you


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