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Monitoring Levels of Quality in Medicare Services
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accuracy admission appropriate Assessing Quality bills Carrier and Intermediary charges claims data clinical coordination costs coverage criteria currently data elements data system determine Developing a Medicare diagnostic codes electrocardiograms evaluation example Existing Data Resources funding guidelines HCFA'S health services research HMOS and CMPS identify initial inpatient inpatient hospital intensified review Intermediary and Carrier Intermediary Medical Review issues Medicaid medical necessity medical records Medicare beneficiaries Medicare program Medicare Quality Assurance methods mortality National NCHSR&HCTA neopl nosocomial infections nursing home ongoing outpatient Peer Review Organizations percent physical therapy physician plans posthospital premature discharges PRO'S procedures profiles PROMPTS-2 PROS prospective payment prospective payment system quality assessment Quality Assurance Strategy quality problems quality review quality screens quality-related readmissions Recommendation Reimbursement report to HCFA Resources for Assessing responsibilities review activities simple mastectomy skilled nursing facility specific standards studies SuperPRO tion types utilization utilization review