View the Medi-Cal Per Diem Contract Expected Reimbursement (Inpatient) Detail
Use the following procedure to view the Medi-Cal Per Diem Contract Expected Reimbursement (Inpatient) Detail.
Note: If the Expected Reimbursement Detail is incomplete, click a Service Type link.
Procedure
- Access the Expected Reimbursement Detail page for a Medi-Cal account. For more information, refer to View the Expected Reimbursement Details .
- Review the expected reimbursements.
- Optionally, you can perform the following actions:
- Click View in the Calculation Details to display the Calculation Details page. For more information, refer to View Expected Reimbursement Calculation Details.
- Click Re-calculate as Medicare IPPS to display the Medicare Outpatient Calculator. For more information, refer to Use the Medicare Outpatient Calculator.
- Click Re-calculate as TRICARE IPPS to display the TRICARE Outpatient Calculator. For more information, refer to Use the TRICARE Non-OPPS Calculator.
Field Descriptions – Medi-Cal Accounts
The following table describes the fields on the Expected Reimbursement Detail page for Medi-Cal Per Diem Inpatient claims. The fields are listed in alphabetical order.
|
Field |
Description |
|
Effective Date |
Effective date of the current contract rates |
|
Error Code |
Reason for rejection or return, if applicable |
|
Line Error |
Error code for a line item |
|
No. |
Sequential reference number of the line item |
|
Paid Units |
Quantity paid |
|
Per Diem Rate |
Per diem rate reimbursement |
|
Provider Number |
Provider’s tax ID number or ten-digit National Provider Identification (NPI) number required on all claims |
|
Revenue code |
|
|
State ID |
Two-letter state identifier used by Medicare (e.g., CA) |
|
Total Reimbursement |
The calculated reimbursement based on the predefined contract terms and conditions and service type definitions in the system and the repriced claims data |