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Prospective rate setting is the method of setting payment rates before the delivery of health care services. Under the retrospective rate setting, third parties usually:
Prospective rate setting is the method of setting payment rates before the delivery of health care services. Under the retrospective rate setting, third parties usually: A. Review historical payment trends to establish current payment rates B. Establish payment rates before the period to which they will apply, which are not subject to change C. Determine an interim payment rate and, during the rate period make payment for services rendered using that rate D. Attempt to adjudicate claims
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