ESRD PRICERActive
Medicare ESRD PPS editing and reimbursement calculation
ESRD PRICERActive™ Editor and Reimbursement DLLs
ESRD PRICERActive processes according to the specifications of the Medicare End Stage Renal Disease prospective payment system (ESRD PPS) as implemented by the Medicare Improvements for Patients and Providers Act (MIPPA).
The ESRD PRICERActive Editor DLL identifies comorbidities and outlier services on a claim for payment under the End Stage Renal Disease Prospective Payment System (ESRD PPS) while the ESRD PRICERActive Reimbursement DLL computes the Medicare End Stage Renal Disease (ESRD) payment amount per session according to the ESRD PPS payment specifications.
Availability:
The ESRD PRICERActive™ Editor and Reimbursement DLLs interface directly with all .Net capable systems and are available as components that implement the ESRD PPS functionality. These products utilize Microsoft SQL Server data components for high-performance in large-scale enterprise and web-based applications.
Features include:
Identification of comorbidities and outlier services that affect Medicare ESRD payment
Calculates the ESRD PPS payment, geographically weighted using the wage index of the provider
Applies case-mix adjustment factors for:
Patient age
Body surface area
Body mass index
Patient comorbidities
Onset adjustment
Pediatric and training adjustments
Calculates the ESRD outlier payment as part of the per-session payment if applicable
Calculates the ESRD add-ons for transitional drugs, supplies, and capital-related assets
Compatible with the leading Windows development environments including:
Microsoft Visual Studio
Microsoft .Net Core (.Net, 6, 7, 8)
Microsoft .Net Framework 4.6.2+
Microsoft SQL Server
Licensing:
ESRD PRICERActive™ components are licensed based upon usage.
For a single site installation, like a health plan, hospital, or university, the ESRD PRICERActive™ is licensed for internal use based on the size of the installation.
For a Software Developer including ESRD PRICERActive™ in a software package for distribution to an end user, a distribution agreement is required. Terms: an initial license fee and a per-site fee for ESRD PRICERActive™.
Send e-mail to salesinfo@microdynmed.com or call for more information and pricing.