RESULTS: Ministry of Health (MoH) is responsible for medicines’ and MDs’ registration, while Social Security Institution (SSI) is the payer and the decision-maker for reimbursement rules; defined by SUT. Holding CE-mark and MoH approval are prerequisites for reimbursement. All MDs are subject to generic listing: there are specialty-based positive lists, consisting of generic definitions and cod...

Reimbursement strategies represent a key tool in implementing public policy. Often the relationship between changes in reimbursement policy and changes in provider behavior is difficult to predict, particularly in complex service systems. Here we present findings from a multiyear study involving the comparison of alternative Medicaid reimbursement systems for intensive case management services:...

The 22 modifier is a Current Procedural Terminology code modifier that allows surgeons to receive additional reimbursement for complex procedures. The goal of this study was to evaluate the rate of, time to, and factors affecting reimbursement for 22-modifier cases filed by orthopedic surgeons. The authors reviewed the charts and billing data of the 150 noncharity spine and total joint replacem...

BACKGROUND Some anesthesiologists avoid provision of obstetric analgesia services (OAS) because of low reimbursement rates for the work involved. This study defines the manpower costs of operating an OAS in a tertiary referral center and examines reimbursement for this cost. METHODS The time spent providing OAS in a total of 55 parturients was studied prospectively using a modification of cla...

BACKGROUND The simultaneous improvement of the security capability of China Health Insurance System and its development in the last decade remains uncertain. This study measures the status and trends of reimbursement levels of the China Health Insurance System, as well as to offer policy advice to subsequent insurance reforms. METHODS The National Reimbursement Ratio was created to determine ...

Background: The purpose of this study was to investigate the rate of coding errors and its effect on the amount of correct reimbursement to patients. Methods: This descriptive and cross-sectional study was performed in 2018. Research resources were records in compensation units in medical documents center of social security organization. A total of 546 re...

OBJECTIVE To identify, categorize and examine performance-based health outcomes reimbursement schemes for medical technology. METHODS We performed a review of performance-based health outcomes reimbursement schemes over the past 10 years (7/98-010/09) using publicly available databases, web and grey literature searches, and input from healthcare reimbursement experts. We developed a taxonomy ...

Reimbursement lists: A. Generics/other less expensive drugs with good cost-effectiveness: 90% reimbursement B. Essential but more expensive drugs: 50% reimbursement C. Specified conditions, prescribed by specialists: C1: Ambulatory care medicines for severe/ chronic diseases C2: Hospital only C3: A+B plus additional OTC products limited to persons <18 years old, students, pregnant women and you...

OBJECTIVES The objective of this study was to assess the frequency of utilization and reimbursement of the common diagnostic tests and treatment modalities used in testicular cancer care. METHODS LifeLink™ (IMS Health, Danbury, CT, USA) Claims Database was used. We identified 877 subjects with a primary diagnosis of testicular cancer (ICD 186.9) between 2007 and 2012. Median reimbursement and...

Telemedicine has garnered significant attention over the past decade as a solution to cost and access challenges facing healthcare. Yet, utilization rates have not reached their full potential. One major barrier to the adoption of telemedicine cited in the literature is the lack of universal reimbursement from private payers. The purpose of this investigation was to capture a current picture of...