View the New York Medicaid IP Expected Reimbursement Detail

Use the following procedure to view the New York Medicaid Expected Reimbursement Detail.

Note: If the Expected Reimbursement Detail is incomplete, click a Service Type link.

Field Descriptions – New York Medicaid IP Accounts

The following table describes the fields on the Expected Reimbursement Detail page for New York Medicaid IP claims.

Field	Description
Bad Debt and Charity Care Allowance	Bad Debt and Charity Care Allowance
Capital Cost Per Day	Flat rate added to the operating blended cost rate per day to determine the inlier case payment
Capital Cost Per Discharge	Flat rate added to the operating blended cost rate per discharge to determine the inlier case payment
Covered Charges	Amount of charges covered by Medicare, Workers’ Compensation or TRICARE
Covered Days	Number of covered days
DRG	Diagnosis Related Group. If the DRG was submitted with a Severity of Illness code, it displays as DRG-Severity Code, for example, 001-2.
DRG Weight	DRG weight factor established by Medicare for each DRG
Effective Date	Effective Date
Error Code	Reason for rejection or return, if applicable
Financially Distressed Allowance	Financially Distressed Allowance
Healthcare Services Allowance	Healthcare Services Allowance
Inlier Case Payment	Calculated by multiplying your facility’s specific operating blended cost per case rate by the DRG weight and then adding your facility’s specific capital cost per case
Operating Blended Cost Rate	The operating blended cost rate for your facility used to calculate the inlier case payment
Outlier Amount	Total amount for extraordinarily high cost (cost outlier)
Per Diem Amount	Per diem payment
Provider Number	Provider Number
Reimbursement Type	Reimbursement type, either expected reimbursement or RA, if applicable (the latest RA is shown if there are multiple RAs)
State ID	The two-letter state identifier.
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
Transfer Amount	Transfer Amount