A traditional payment model in healthcare where providers are reimbursed based on the number and type of services they deliver to patients, regardless of the outcome.
The process of compensating healthcare providers for the services rendered to patients under the FFS model.
A patient-provider interaction during which healthcare services are provided, typically resulting in a claim for reimbursement under the FFS system.
Current Procedural Terminology codes used to identify specific medical procedures and services provided by healthcare professionals, facilitating accurate billing under the FFS model.
International Classification of Diseases codes used to classify and code diagnoses, symptoms, and procedures for billing and reporting purposes in the FFS system.
The practice of assigning higher-level billing codes than justified by the services rendered, potentially resulting in increased reimbursement under the FFS model.
The process of assigning lower-level billing codes than warranted by the services provided, leading to reduced reimbursement under the FFS system.
Separating a bundled group of services into individual billable components to maximize reimbursement in the FFS model, often considered fraudulent if done improperly.
A list of predetermined fees or reimbursement rates for specific healthcare services under the FFS system, serving as a reference for billing and payment calculations.
An alternative payment model focused on improving patient outcomes and controlling costs by rewarding healthcare providers based on the quality and efficiency of care delivered, contrasting with the volume-based reimbursement of the FFS model.