The ASC PRICERActive™ Reimbursement DLL

Beginning in fiscal year 2008, Medicare implemented a payment system for procedures performed in an Ambulatory Surgical Center (ASC) that is based on the APC groupings of the Outpatient Prospective Payment System (OPPS). Medicare only allows payment to ASCs for procedures that are specified on the ASC list. ASC procedures are those surgical and other medical procedures that are:

• Commonly performed on an inpatient basis but may be safely performed in an ASC

• Limited to procedures requiring a dedicated operating room or suite and generally requiring a postoperative recovery room or short-term (not overnight) convalescent room

The ASC PRICERActive™ Reimbursement DLL duplicates the calculations used by Medicare for ambulatory surgical center payment. ASC PRICERActive‘ uses the same formulas and data that the Medicare uses to calculate claim payments. With ASC PRICERActive‘ you can calculate an estimated Medicare payment for any ASC facility in the U.S. along with the standard ASC beneficiary coinsurance.

Availability:

The ASC PRICERActive™ Reimbursement DLL is available in .Net format and utilizes Microsoft SQL Server data components for high-performance in large-scale enterprise and web-based applications.

Features include:

• Determines the presence of qualifying covered surgical procedures
• Calculates the CMS standard ASC reimbursement, geographically weighted using the provider wage index.
• Applies multi-procedure discounting where appropriate
• Applies payment adjustments for cases with device credits
• Calculates ASC standard beneficiary coinsurance

Compatible with the leading Windows development environments including:

• Microsoft Visual Studio
• Microsoft .Net Core (.Net, 6, 7, 8)
• Microsoft .Net Framework 4.6.2+
• Microsoft SQL Server

Licensing:

ASC PRICERActive™ components are licensed based upon usage.

For a single site installation, like a health plan, hospital, or university, the ASC PRICERActive™ is licensed for internal use based on the size of the installation.

For a Software Developer including ASC PRICERActive™ in a software package for distribution to an end user, a distribution agreement is required. Terms: an initial license fee and a per-site fee for ASC PRICERActive™.

Send e-mail to salesinfo@microdynmed.com or call for more information and pricing.