The New APR-DRG Payment Method
The Montana Department of Public Health and Human Services (DPHHS)
will move to a new method of paying for hospital inpatient services.
Our goals are to implement a DRG grouper appropriate to Medicaid, reduce
complexity, improve incentives, and reduce reliance on Medicare cost
reports.
Frequently Asked Questions (Updated August 12, 2008)
Training PowerPoint (Updated August 12, 2008)
Pricing Examples (Updated August 12, 2008)
Pricing Calculator and Weights and Treshholds (Updated August 27, 2008)
3M PowerPoint (Updated August 13, 2008)
Claim Processing and Editing Guide PowerPoint (Updated October 13, 2008)
Letter Regarding Changes to Prior Authorization and Reimbursement Methodology (generic) (Updated September 5, 2008)
Letter Regarding Changes to Prior Authorization and Reimbursement Methodology (preferred) (Updated September 5, 2008)
Prior Authorization Provider Notice (Updated September 3, 2008)
Present on Admission Indicator Provider Notice (Updated September 30, 2008)
Interim Claims Provider Notice (Updated September 3, 2008)
