Question: Complete the reimbursement amount template provided in the case for CPT 73722 (MRI of the knee) and DRG 470 (major joint replacement). Discuss the fairness
Complete the reimbursement amount template provided in the case for CPT 73722 (MRI of the knee) and DRG 470 (major joint replacement). Discuss the fairness and efficiency of the current fragmented reimbursement system to providers, insurers, patients, and society (the ultimate bearers of healthcare costs).
b. Assume that MRHSs payer mix is 46 percent Medicare, 34 percent commercial/managed care, 16 percent Medicaid, and 4 percent self-pay/no insurance. Calculate the average expected payment for each of the two procedures.
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