Because end-stage renal disease (ESRD) facilities can maintain their current Medicare exception rates or become subject to the new Medicare case-mix adjusted composite rate, they should compare the two to determine the best payment rate for their facility.
The ESRD Calculator from the Centers for Medicare & Medicaid Services is a spreadsheet that lets you enter information to predict reimbursement based on various patient characteristics. It may be especially useful for facilities that are considering giving up their exception rate and want to forecast payment for the services they provide.
In addition, it may be helpful to those wanting to calculate the payment they will receive for a particular claim so they can accurately post accounts receivable, or even simply to validate that they have received correct payment for a claim upon receipt of their Medicare remittance advice.
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