View the Ohio Medicaid Inpatient Expected Reimbursement Detail

Use the following procedure to view the Ohio Medicaid Inpatient Expected Reimbursement Detail.

Field Descriptions – Ohio Medicaid Inpatient Accounts

The following table describes the fields on the Expected Reimbursement Detail page for Ohio Medicare Inpatient claims.

Field	Description
Capital Allowance	An allowance for capital costs that is added on to each claim payment
Cost Outlier Payment	A cost outlier occurs if a hospital's charges exceed a specified amount above the statewide average price. There are two types of outliers: day and cost outliers. The name of this column changes, dependent upon the type of outlier present on the account.
Covered Charges	The amount of covered charges
Covered Days	Number of covered days
CTC Ratio	Facility-specific charge-to-cost ratio
Day Outlier Payment	A day outlier occurs if the beneficiary's length of stay exceeds the statewide average by a specified amount. There are two types of outliers: day and cost outliers. The name of this column changes, dependent upon the type of outlier present on the account.
DRG	Diagnosis Related Group code. If the DRG was submitted with a Severity of Illness code, it displays as DRG-Severity Code, for example, 001-2.
DRG Payment	The DRG payment prior to the addition of allowance and outlier payments
DRG Weight	DRG weight factor established by Medicare for each DRG
Education Allowance	An allowance for teaching hospitals that is added to each claim payment
Effective Date	Effective date of the current contract rates
Error Code	Reason for rejection or return, if applicable
Non-covered Charges	The amount of non-covered charges (not disallowed charges)
NPI	Facility’s ten-digit National Provider Identification (NPI) number required on all claims
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)
State ID	Two-letter state identifier used by Medicare (e.g., TX)
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 Payment	Payment amount if UB has a transfer discharge status; in place of DRG Inlier payment