Cost-Based, Charge-Based and Contractual
Payment Systems
Duane C. Abbey
Abbey & Abbey Consultants, Inc., Ames, Iowa, USA
ISBN: 978-1-4398-7299-4, March 2012, c. 175 pp., Soft Cover
This fourth book in the Healthcare Payment Systems Series provides an overview of
a wide range of healthcare payment systems. It compares cost-based systems,
charge-based payment approaches, and contractually-based payment processes to
fee-schedule payment systems and prospective payment systems. It covers claim
adjustment and compliance as well as managed care contracts and various combinations
of payment systems used by third-party administrators. Examples illustrate
the processes used for capitated contract arrangements. The author also addresses
various compliance issues, including statutory, contractual, and overpayment issues.