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Hi Celine, Thank you for your query. The PPCP is made up of two parts, a County Base Rate to cover PPCP-eligible services (Prospective Primary Care Payment County Base Rate) and an Enhanced Amount for providing enhanced primary care services (Prospective Primary Care Payment Enhanced Amount). The amount of payment made by CMS to the ACO will depend on the County Base Rate, which is derived from the average primary care spending in its county, and the Enhanced Amount(s) based on characteristics of the ACO and its assigned patient population. For most model participants, CMS expects that the PPCP will increase primary care funding relative to ACOs’ historical expenditures. (Retrieved from CMS ACO Primary Care Flex Model FAQs) Hope this helps.

My pleasure

Hi! Thank you for watching my video. My schedule is full until the middle of April. If you like, you can email me your specific questions now and contact me in the latter half of April if that'll work for you.

Hi, Thanks for bringing it to my attention. I have replaced it with another link in the description box of the video. When you click on the new link, it'll take you to the webpage on Patient Driven Payment Model. Go down to the section on "PDPM Resources" and you'll see the link to FY 2024 PDPM ICD 10 Mapping there. Hope this helps.

Glad to hear that you liked the video! Yes, physicians are paid separately under the Physician Fee Schedule for their professional services provided during the inpatient stay.

@@QualityConsultant169 Thank you, that's very helpful!

How do I calculate inpt days (outlier) using their 60/30/60. I am trying to get a better understanding of this

Hi Sylvia, Thanks for your question, but I am not an expert in claims. Not sure what state you are in, but there is some information on outlier coding and guidelines on the Novitas (MAC) webpage below. This may help. www.novitas-solutions.com/webcenter/portal/MedicareJL/pagebyid?contentId=00003594

Hi Dee! Open enrollment period is from October 15 - December 7 each year. What I have read is that new plan quality ratings come out each October before fall open enrollment.

Thanks!

Tom, Thank you for your input.

Thanks

Thank you so much 😀

Will do. Thanks!

Hi M. Rahul! Thank you for your feedback. I'll put Payor on my list of videos to create. However, claims is not my expertise. Thanks for reaching out to me!!

Hi Perry! The hospitals I worked at had CLIA laboratories.

Hi Perry! The hospitals I worked at had CLIA laboratories.

@@QualityConsultant169 Are We Able To Speak??

@@perryjonesjr7472 I prefer that we communicate via e-mails initially. If still interested, please select the "About" tab of my channel, you'll see my description. Below my description, there is a tab to send e-mails for business inquiries. Select "VIEW EMAIL ADDRESS". Thanks!

Hi Tony! You are right. Thank you for catching the error.

Glad it was helpful!

Glad it was helpful!

Glad that you found it informative. Thank you for watching!!