View the Oklahoma Medicaid Outpatient Expected Reimbursement Detail

Use the following procedure to view the Oklahoma Medicaid Outpatient Expected Reimbursement Detail (IPPS Payment).

Field Descriptions – Oklahoma Medicaid Outpatient Accounts

The following table describes the fields on the Expected Reimbursement Detail page for Oklahoma Medicaid Outpatient claims.

Field	Description
APC Group	Ambulatory Payment Classification group number assigned to the procedure.
APC Rate	Ambulatory Payment Classification rate applied to the account.
ASC Rate	Ambulatory Service Center rate applied to the account.
Billed Charges	The total charges incurred for the claim or set of claims that have been repriced.
Billed CPT Code	CPT code billed.
Billed Units	Number of units billed.
Effective Date	Effective date of the current contract rates.
Error Code	Reason for rejection or return, if applicable.
Flat Rate	Flat rate used to calculate reimbursement for observation, labor and delivery observation, chemotherapy, IV administration, physical therapy, occupational therapy, speech therapy, and other therapeutic services.
FFS	Maximum allowable fees for charges submitted by imaging, X-ray clinics, laboratories, Fee-For-Service hospitals, and dentists providing medical services.
Insure FFS	Displays values for the detail lines when the reimbursement tool is setup to use the Insure Fee Schedule. The FFS column values for the details lines are set to display 0.00.
Paid Units	Quantity paid.
Provider Number	Provider’s tax ID number or ten-digit National Provider Identification (NPI) number required on all claims.
Reimbursement Type	Reimbursement type, either expected reimbursement or RA, if applicable (the latest RA is shown if there are multiple RAs).
Rev Code	Revenue code.
Service Date	Date the service was rendered.
State ID	Two-letter state identifier used by Medicare (for example, OK).
Total Expected Reimbursement	The calculated reimbursement based on the predefined contract terms and conditions and service type definitions in the system and the repriced claims data.