MS DRG Reimbursement Conversion for Hospitals in 2014
Blue Cross and Blue Shield of North Carolina (BCBSNC) began notifying participating hospitals in 2013 that payment methodology would be converted from AP-DRG to MS-DRG prior to October 1, 2014.
MS-DRG, used for Medicare reimbursement, is also widely used by many third-party payers. This conversion will impact all hospitals currently with contracts that include AP-DRG or type-of-case reimbursement methodologies. To ensure uninterrupted payment, all impacted hospitals must be converted to MS-DRG by October 1, 2014.
BCBSNC Network Management Contracting staff will be contacting each impacted hospital to discuss its respective conversion schedule.