运动计费是医药:对身体活动相关计费代码的报销趋势的分析
Lucas J Carr1, Britt Marcussen2, Tyler Slayman2
1Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA.
Journal of physical activity & health
|December 10, 2024
概括
第三方付款人很少拒绝体育活动咨询费用,尽管一些因素增加了拒绝的几率. 这项研究分析了计费数据,以了解与生活方式相关的医疗服务的报销.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床实践整合 临床实践整合
- 医疗保健经济学 医疗保健经济学
背景情况:
- 身体不活动是一个主要的健康风险,推动了诸如"运动是药物" (Exercise is Medicine®) 等倡议.
- 将体育活动咨询纳入医疗保健中受到补偿挑战的阻碍.
- 了解收费和报销是广泛采用体育活动咨询的关键.
研究的目的:
- 为了分析一家大型美国医院体育活动咨询的计费数据.
- 确定这些服务的报销率和拒绝模式.
- 确定影响身体活动咨询索赔拒绝的因素.
主要方法:
- 利用美国中西部一家医院12个月的账单数据.
- 检查了与ICD-10和EM代码相关的费用,退款和拒绝率.
- 采用后勤回归来识别与索赔拒绝相关的因素.
主要成果:
- 超过780万美元的指控被提交,拒绝率为5.28% (414,446美元).
- 常见的诊断包括肥胖和久坐不动的生活方式;大多数费用是门诊访问.
- 雇主支付的保险,医疗补助和医疗保险是主要支付者;较新的患者和较短的访问增加了拒绝的风险.
结论:
- 身体活动咨询费用显示,第三方付款人的拒绝率很低.
- 这项研究为体育活动咨询的计费和报销提供了新的见解.
- 对其他美国卫生系统的概括性需要进一步调查.
相关概念视频
01:30Health Information Technology and Healthcare Information System
799
Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
799
01:29Issues And Trends In Healthcare Delivery System
5.6K
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
5.6K