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Having trouble explaining to your Medicare patients what the new ambulatory payment classifications mean to them? Here’s a sample letter recently circulated among members of the National Association of Healthcare Access Management that you may want to use as a blueprint for your own communication with patients:
Dear Medicare Recipient:
The federal government began a new system for reimbursing hospitals for providing care to Medicare patients effective Aug. 1, 2000. This change applies only to payment for outpatient services and is called the "outpatient prospective payment system." It involves a predetermined rate for reimbursement called "ambulatory payment classifications." It is important that you be aware of this change as it may affect your hospital bill.
You may be aware that you are responsible for paying a portion of the total charges for your care that Medicare does not cover. This is called "coinsurance." One of Medicare’s goals, over time, is to reduce the amount of coinsurance that is due. The senior group American Association of Retired Persons (AARP) has supported this change for this reason. However, these reductions will not occur immediately in all circumstances for all beneficiaries. The coinsurance amounts for outpatient services are based on a national average. But fees for these services, based on the cost of providing them, are not the same across the country. Therefore, at least in the short run, some Medicare beneficiaries may actually experience an increase in coinsurance due for certain services provided. Please be aware that Medicare has established these fees, not the hospitals.
Hospitals will continue to provide the highest quality of care while meeting the challenges of these changes. Questions may be directed to the Medicare Help Line at (800) 633-4227. You may also contact your local AARP office. If you have specific questions regarding your current hospital bill, please call _______________.