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CCH Reimbursement Toolkit

CCH Reimbursement Toolkit



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Forecasting Medicare revenue is critical. 58% of hospitals lose money treating Medicare patients. This number is expected to increase to 65% by 2005. What if there was a tool to forecast reimbursement from CMS?

The CCH Reimbursement ToolKit is your one-stop shop for forecasting accurate Medicare reimbursement under prospective payment systems (PPS) from the Centers for Medicare and Medicaid Services (CMS). It is a cost-effective way to supplement or audit expensive contract management tools and billing systems, as well as a time-saving alternative to maintaining complex, "home-grown" Excel spreadsheets. Containing 2004 and 2005 data, the information is always up to date and links to related laws, regulations and Final Rules to ensure compliance. It also incorporates cost report figures for accurate forecasting of reimbursement. Most importantly, the CCH Reimbursement ToolKit is comprehensive in its inclusion of seven PPS methodologies--including the Inpatient Psychiatric Facility calculator (the Final Rule was released in November 2004). These seven calculators are:

  • Inpatient: IPPS (DRG plus outlier)
  • Outpatient: OPPS (APC plus outlier)
  • Long-term Care Hospital: LTCH PPS (LTC plus outlier)
  • Inpatient Rehabilitation Facility: IRF PPS (CMG plus outlier)
  • Physician Fee Schedule
  • Skilled Nursing Facility: SNF PPS
  • Inpatient Psychatric Facility: IPF PPS

Where applicable, the calculators will also determine whether or not a case qualifies for outlier payment and determine that outlier payment rate. You can print, save or email reports generated by the calculators. In addition, laws, regulations and final rules on which the calculations are based are linked from the CCH Medicare and Medicaid Guide to the calculators.

Now New & Improved

  • Easier to use. Now all you need to do is simply enter your Provider Number to obtain calculation results—no geographic classification will be required. Additionally, the Wage Index Data now includes blended wage values for superior accuracy.
  • Faster results. Calculate up to 100 codes at a time! We've increased the capability of entering codes from 25 to 100—helping you run calculations more quickly.
Product Line Wolters Kluwer Legal & Regulatory U.S.
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