To assist hospital staff, trustees, Congressional staff, and others to better understand the various Medicare payment arrangements, the Florida Hospital Association has developed Medicare 101: An Overview of Medicare Payment Systems. The publication captures payment arrangements from hospital inpatient and outpatient services to post-acute care, physician reimbursement, and rural providers. In addition, we have included an overview of payment requirements for Medicare Advantage (MA) plans to non-contracted providers and frequently asked questions specific to MA. It is the intent of the Florida Hospital Association to update this guide as payment systems change. We would expect to see minor changes, although perhaps significant in financial impact, to existing payment systems on nearly a monthly basis.
The purpose of this publication is to provide a general understanding of the various Medicare payment systems. It is not a billing guide. Providers are referred to their Medicare Administrative Contractor (MAC) for claims submission inquiries.
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