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Determine total payment:
Mrs. Smith is a 70-year-old and hospitalized for a Kidney Transplant procedure. General Hospital is a large urban hospital in San Francisco that incurred $150,000 in Medicare approved charges in treating Mrs. Smith. Please use the information provided in this module as well as the Hospital Payments Example, which can be found in the Module 4 Presentation section, to answer the following questions. Be sure to include all formulas and calculations in your paper.
DRG
Description
Case Weight
115
Permanent Cardiac Pacemaker
3.5513
302
Kidney Transplant
4.1370
441
Hand Procedure/Surgery
0.8785
Please answer the following questions for Kidney Transplant ONLY:
1. What is the operating payment to be paid to the hospital?
2. What is the capital payment to be paid to the hospital?
3. Will the hospital be eligible for the Medicare outlier payment?
4. What is the total payment to the hospital?
Case assignment expectations:
1. Consider the following balance sheet: Best Care HMO Balance Sheet June 30, 2007 Assets / Current Assets*
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