Accession Number : ADB167596

Title :   Tri-Service CHAMPUS Statistical Database Project (TCSDP): Partnership Provider Audit Report for Fort Benjamin Harrison MEDDAC Catchment Area (Privacy Act Protected) Fiscal Year 1991. Gateway to Care Management Analysis Series.

Descriptive Note : Final rept. Oct 90-Sep 91,

Corporate Author : ARMY HEALTH CARE STUDIES AND CLINICAL INVESTIGATION ACTIVITY FORT SAM HOUSTON TX

Personal Author(s) : Optenberg, Scott A. ; Moon, Kathleen A.

Report Date : 03 SEP 1992

Pagination or Media Count : 60

Abstract : This report supplements thirteen reports, RP 92-021 through RP 92-033, which analyze services and costs of all providers identified as part of the Health Services Command CHAMPUS partnership program. Only data for the Fort Benjamin Harrison MEDDAC catchment area is presented in this report, and partnership provider names and identification numbers have been Privacy Act protected by deletion and replacement with the words PRIVACY ACT . As in the other reports in this series, each of two appendices is presented for the Fiscal Year (FY) 1991 by billable medical treatment facility catchment area, Army Occupational Code/major specialty code of the partnership provider, provider name, and provider identification number. Appendix A presents for each provider ID: (1) the type of professional service performed (inpatient/ambulatory); (2) the total number of services and visits; (3) the totals of amounts billed, allowed, paid by private insurance; and (4) the total amount paid by the government for partnership claims. Appendix B delineates for each CPT-4 procedure code furnished by the provider: (1) the total amounts billed and allowed; (2) the total government payment; (3) number of services; (4) average government payment per service; (5) number of episodes of care; (6) average government payment per episode; and (7) the percent of services to the total number of services for the provider ID. The sort sequence is shown through examples of hypothetical provider names and numbers. CHAMPUS; Partnership Providers; Medical Treatment Costs; Gateway to Care.

Descriptors :   *COSTS, *MEDICAL SERVICES, HEALTH, IDENTIFICATION, INSURANCE, REPLACEMENT, SEQUENCES, HEALTH CARE FACILITIES, MILITARY PERSONNEL, FAMILY MEMBERS.

Subject Categories : Medicine and Medical Research
      Economics and Cost Analysis

Distribution Statement : APPROVED FOR PUBLIC RELEASE