|
. |
 |
Provider Selection & Reimbursement ....
The hospitals in the Flora network provide
the full range of hospital services. Flora carefully structures the
network to provide comprehensive access to services within each
geographical region. Hospitals are targets for inclusion in the
network based on their breadth of services, accreditation, geographic
location, charges/cost structure and the reputation of the facility and
its medical staff. Flora determines reimbursement for all hospitals
based upon a percentage of charges, comprehensive Per Diem rates covering
medical and surgical care, or Diagnostic Related Groups (DRG's).
Outpatient charges are set for reimbursement through specific fee
schedules or a percentage of charges.
Flora's selection criteria covers education and training, licensure, board
certification, malpractice history, liability insurance coverage and
overall quality and cost effectiveness of care.
Applications are scrutinized by the provider relations staff who carefully
verify each provider's credentials. Additionally, Flora regularly
reviews and verifies license status from each state's licensing and
medical board documentation.
Flora's fee schedule is based upon the Medicare Resource Based Relative Value
Scale (RBRVS). The fee schedule is continually reviewed,
incorporating base unit modifications for some regions.
|
  
|
|
. |
