View the Expected Reimbursement Detail for Daily Charge Grouping

Use the following procedure to view the Daily Charge Grouping detail on the Expected Reimbursement Detail page. This section only displays if the contract profile uses the Daily Charge Grouping reimbursement tool.

The Daily Charge Grouping reimbursement tool defines reimbursement for services that are based on a per visit basis (with a single date of service), such as infusion therapy where the visit is separated from any associated pharmacy, lab, or radiology charges for the visit. For more information about the bundling reimbursement tool, refer to Daily Charge Grouping.

Field Descriptions – Daily Charge Grouping

The following table describes each of the fields in the Daily Charge Grouping section of the Expected Reimbursement Detail page. The fields are listed in alphabetical order.

Field	Description
Charged Amount	Total billed charges for the selected codes.
Code	The code from the fee schedule used to calculate reimbursement.
Date of Service	Dates the service was rendered. If there are multiple events on the same claim, the charges are grouped and sub totaled by service date.
Expected Amount	The calculated reimbursement based on the parameters defined in the Daily Charge Grouping reimbursement tool.
Limit Value	The value used to limit reimbursement. In the Daily Charge Grouping reimbursement tool, you can choose to limit the reimbursement so that it is no greater than or no less than a specified amount or percentage. If this field is blank, no limit was set.
Method	The calculation method used to calculate expected reimbursement. Values include Percentage, Flat Amount, and Table Lookup (fee schedule). The table lookup value includes a link to view the details of the fee schedule.
Reimbursement Group (by day)	The code or group of codes grouped together for reimbursement by the Daily Charge Grouping reimbursement tool. This field displays one of the following: Single code (612) Series of codes (612,615,350) Range of codes (612-620) Lookup table name that includes any codes in the listed table Note: “Remaining” in this field indicates reimbursement for all remaining codes with the same service date as the event that are not specifically listed in the reimbursement tool.
Service Date	Date the service is rendered.
Service Type	Service type name. Click this link to display the service type on the View Contract Profile page. For more information, refer to View a Contract Profile.
Term Type	A link that allows you to view the contract profile. For more information, refer to View a Contract Profile.
Units	Number of units billed.
Value	The calculation percentage or flat rate used to calculate expected reimbursement. If a fee schedule was selected as the method, this field is left blank.