Field Descriptions
Note: The following table describes the fields on the IN tab of the Medicaid - Facility reimbursement tool.
|
Field |
Description |
|
Override Provider Number |
Preferred provider number. Up to ten alphanumeric digits. Enter the NPI number in this field if either the Use APR-DRG or Use EAPG check boxes are selected. |
|
Override Service Date |
Preferred service date. Use MM/DD/YYYY format. Overrides the service date on the claim with the date you enter. You may use the anchor date instead of this option. |
|
State Code |
This field defaults to IN, and it cannot be changed. |
|
Do not consume charges |
Provides the option not to consume charges. This is used for contract carve outs. |
|
Do not consume units |
Provides the option not to consume units. This is used for contract carve outs. |
|
HAF Facility |
Hospital Assessment Fee |