The 3M clinical grouping solutions calculate expected reimbursement using predefined logic and a custom rate schedule. You can define the parameters—hospital values, statistics files, and other reimbursement variables—governing payment processing of your patient claims. Look below to find out what national groupers are available.
3M software also allows hospitals and other interested parties to model grouping and pricing software used by national payers. The software considers regional and hospital-specific factors such as wage areas and graduate medical education payments.
The Centers for Medicare & Medicaid Services (CMS) Inpatient Prospective Payment System – CMS DRGs and Medicare Severity Diagnosis Related Groups (MS-DRGs) – were developed for classifying claims for Medicare patients in acute care hospitals, long-term care hospitals (LTCHs) and inpatient psychiatric facilities.
The Centers for Medicare & Medicaid Services (CMS) Outpatient Prospective Payment System – CMS Ambulatory Payment Classifications (APCs).
The TRICARE Inpatient and Outpatient Prospective Payment System -- Developed and maintained by 3M for the Department of Defense (DoD), this system includes additional DRGs not related to the Medicare population and is used by the Department of Veterans Affairs and DoD facilities.
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3M APR DRGs use standard patient discharge information to classify patients into clinically meaningful groups, then into four severity-of-illness and four risk-of-mortality subclasses.
3M APR DRG fact sheet (PDF, 84 KB)
3M Enhanced APGs provide an up-to-date framework for analyzing and managing outpatient care, giving health care providers a powerful tool that captures changes in clinical practice and resource use.
3M CRGs are a categorical clinical model that is used to assign each patient to a single, mutually exclusive risk category.
3M CRG fact sheet (PDF, 100.11 KB)
3M can help you manage the full spectrum of potentially preventable events (PPEs), including hospital admissions, readmissions, complications, ED visits and ancillary services.
3M solutions for potentially preventable events fact sheet (PDF, 83 KB)
3M population health and potentially preventable events eGuide (PDF, 822 KB)
3M now offers a complete suite of solutions for grouping, editing and pricing logic, and data you will need to accurately calculate payment for all care settings.
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