Improving Outcomes in Revenue Cycle Management. Module C.
Regulations laid out by the Centers for Medicare & Medicaid Services (CMS), established primarily for Medicare, have set the tone for all of America’s health insurance plans. This module lays out the basics of how this system works, starting by describing the major federal plans, and then detailing what kinds of services Medicare covers. Next, the module draws a distinction between its two payment systems: the inpatient prospective payment system (IPPS) and the outpatient prospective payment system (OPPS).