ASC-PS (Test 4)question correctly answered rated A+ 2023
ASC-PS - correct answer Ambulatory Surgical Center Payment system
Objectives
(this slide might be unnecessary but it seems to be what Sandy wants us to know...?) - correct answer ~ASC Definition
~Identify the components, adjustments, and provisions of the ASC-PS
~Recall the steps for APC assignment
~Identify the payment determination steps for ASC-PS payment
ASC - Definition & Certification Standards - correct answer ~An ASC is a distinct entity that operates exclusively to furnish outpatient surgical services to patients who need no hospitalization and for whom the expected duration of services is less than 24 hours following admission. Medicare ASC patients should not need active medical monitoring at midnight on the day of the procedure
~An ASC must be licensed by the state and Medicare certified
~An ASC can be independent (not part of a provider of services or any other facility) or
ASC - Definition & Certification Standards (cont.)
An ASC can be operated by a hospital (under the common ownership, licensure, or control of a hospital) but must meet the following conditions: - correct answer ~Be a separately identifiable entity, separately certified and enrolled in Medicare with a supplier approval and agreement distinct from the hospital's Medicare provider agreement ~Be physically, administratively, and financially independent and distinct from other hospital operations
~Treat ASC costs as a non-reimbursable cost center on the hospital's cost report
~Agree to the same assignment, coverage, and payment rules applied to independent ASCs
~Be surveyed, approved, and in compliance with the ASC conditions for coverage in 42 CFR 416.25-54
ASC - Medicare Certification Standards
(1 of 2) - correct answer ~A hospital-operated ASC is not the same as a provider-based outpatient surgery hospital department. A provider-based outpatient hospital department, including an outpatient surgery department:
~~May be on or off-campus
~~Is an integral part of the hospital, subject to hospital conditions of participation
~~Is not separately Medicare-enrolled or Medicare-certified, or subject to ASC coverage conditions
ASC - Medicare Certification Standards
(2 of 2)
~To be a MC-certified ASC the following criteria must be met: - correct answer ~~Be a separate entity distinguishable from any other entity or type of facility
~~Have its own national identifier or supplier number from MC
~~Maintain its own licensure, accreditation, governance, professional supervision, administrative functions, clinical services, recordkeeping, and financial and accounting systems
ASC-PS - correct answer Ambulatory Surgical Center Payment system
Objectives
(this slide might be unnecessary but it seems to be what Sandy wants us to know...?) - correct answer ~ASC Definition
~Identify the components, adjustments, and provisions of the ASC-PS
~Recall the steps for APC assignment
~Identify the payment determination steps for ASC-PS payment
ASC - Definition & Certification Standards - correct answer ~An ASC is a distinct entity that operates exclusively to furnish outpatient surgical services to patients who need no hospitalization and for whom the expected duration of services is less than 24 hours following admission. Medicare ASC patients should not need active medical monitoring at midnight on the day of the procedure
~An ASC must be licensed by the state and Medicare certified
~An ASC can be independent (not part of a provider of services or any other facility) or
ASC - Definition & Certification Standards (cont.)
An ASC can be operated by a hospital (under the common ownership, licensure, or control of a hospital) but must meet the following conditions: - correct answer ~Be a separately identifiable entity, separately certified and enrolled in Medicare with a supplier approval and agreement distinct from the hospital's Medicare provider agreement ~Be physically, administratively, and financially independent and distinct from other hospital operations
~Treat ASC costs as a non-reimbursable cost center on the hospital's cost report
~Agree to the same assignment, coverage, and payment rules applied to independent ASCs
~Be surveyed, approved, and in compliance with the ASC conditions for coverage in 42 CFR 416.25-54
ASC - Medicare Certification Standards
(1 of 2) - correct answer ~A hospital-operated ASC is not the same as a provider-based outpatient surgery hospital department. A provider-based outpatient hospital department, including an outpatient surgery department:
~~May be on or off-campus
~~Is an integral part of the hospital, subject to hospital conditions of participation
~~Is not separately Medicare-enrolled or Medicare-certified, or subject to ASC coverage conditions
ASC - Medicare Certification Standards
(2 of 2)
~To be a MC-certified ASC the following criteria must be met: - correct answer ~~Be a separate entity distinguishable from any other entity or type of facility
~~Have its own national identifier or supplier number from MC
~~Maintain its own licensure, accreditation, governance, professional supervision, administrative functions, clinical services, recordkeeping, and financial and accounting systems
