Before submitting the claims to Medicare, the HHRG must be ...

[robinn137]

Before submitting the claims to Medicare, the HHRG must be converted to a Health Insurance Prospective Payment System code (HIPPS).
 
 Indicate whether the statement is true or false

Question 2

List and describe the three areas used to determine the HHRG when establishing the reimbursement rate.

[lkanara2]

Answer to Question 1

TRUE

Answer to Question 2

Clinical, functional, and service utilization. (1) The clinical dimension establishes the score based on primary diagnosis and secondary diagnoses for the top diagnoses on the plan of care: vision, level of pain, presence of wounds, dyspnea, urinary and bowel status, need for infusion, and behavior. (2) The functional dimension assesses the patient's ability to perform activities of daily living such as dressing and bathing safely within the home setting. (3) Service utilization determines what level of service the patient is likely to need based on the number of therapy visits received during the episode of care.