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Policy: BlueCross Blue Shield of Rhode Island covers interim billing for payment of services provided by an acute rehabilitation/skilled nursing facility, hospice or home health agency. Interim billing is covered for acute care hospitals only if the hospital is covered at a per diem rate.
prospective payment system (PPS) a payment mechanism for reimbursing hospitals for inpatient health care services in which a predetermined rate is set for treatment of specific illnesses. The system was originally developed by the U.S. federal government for use in treatment of Medicare recipients. See also diagnosis-related group.