View the APG Expected Reimbursement Detail
Use the following procedure to view the APG Expected Reimbursement Detail.
Note: If the Expected Reimbursement Detail is incomplete, click a Service Type link.
Procedure
- Access the Expected Reimbursement Detail page for an APG account. For more information, refer to View the Expected Reimbursement Details .
- Review the expected reimbursements.
- Optionally, you can perform the following actions:
- Click Reimbursement to display the View Contract Profile page. For more information, refer to View a Contract Profile.
- Click the Service Type name to display the service types on the View Contract Profile page. For more information, refer to View a Contract Profile.
- Click View in the Calculation Details column. The Calculation Details page opens. For more information, refer to View Expected Reimbursement Calculation Details.
Field Descriptions – APG
The following table describes each of the fields on the Expected Reimbursement Detail page for Ambulatory Patient Group (APG) claims. The fields are listed in alphabetical order.
|
Field |
Description |
|
APG Code |
APG code associated with the claim |
|
APG Line Status |
Was paid for by APG if “APG” is present |
|
APG Paid Amount |
Amount paid for each APG for which there was payment (not all APG’s on a claim are paid) |
|
APG Weight |
Factor assigned to each APG that is used to calculate the specific payment for that APG. Ratio of the relative complexity of the APG to the average complexity of all APGs |
|
Charges |
Amount billed by the provider |
|
HCPC/CPT Codes |
Associated CPT or HCPC codes |
|
No. |
Sequential reference number of the line item |
|
Rev Code |
Revenue code |
|
Units |
Quantity billed per line item |