View the South Carolina Medicaid Outpatient (OP) Expected Reimbursement Detail

Use the following procedure to view the South Carolina Medicaid Outpatient (OP) Expected Reimbursement Detail.

The following table describes the fields on the Expected Reimbursement Detail page for South Carolina Medicaid Outpatient (OP) claims.

Field	Description
Error Code	Displays the error code for rejection or return, if applicable.
Provider Number	Provider number assigned to the facility by the State Medicaid office.
NPI	Facility’s ten-digit National Provider Identification (NPI) number required on all claims.
Effective Date	Effective date of the current contract rates.
Facility Multiplier	Displays the facility multiplier.
Reimbursement Type	Reimbursement type, either expected reimbursement or RA, if applicable (the latest RA is shown if there are multiple RAs).
Service Date	Date the service was rendered.
Revenue Code	Displays the Revenue code.
CPT Code	Displays the associated CPT code.
Billed Units	Number of units billed.
Paid Units	Number of units paid.
Billed Charges	The total charges incurred for the claim or set of claims that have been repriced.
FFS Rate	Displays the Fee-for-Service (FFS) rate.
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.
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.
Reason Code	Reason for rejection or return, if applicable.