View the TRICARE (Acute Inpatient) Expected Reimbursement Detail

Use the following procedure to view the expected reimbursement detail for TRICARE Acute Inpatient accounts.

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

Field Descriptions – TRICARE Acute Inpatient Accounts

The following table describes each of the fields on the Expected Reimbursement Detail page for TRICARE acute inpatient claims. The fields are listed in alphabetical order.

Field	Description
Billed Charges	Total billed charges for the product during the selected time period
Blood Clotting Factor Payment	Payment amount if claim includes relevant codes
Cov Charges	Amount of charges covered
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 Inlier Payment	Base payment for all TRICARE claims
DRG Weight	DRG weight factor for each DRG
Error Code	Reason for rejection or return (claim level), if applicable
New Tech Add On	Displays the New Tech add on amount
New Tech VBP Adjustment	Displays the New Tech value base purchasing adjustment
Operating VBP Adjustment	Displays the operating value base purchasing adjustment
Outlier Payment	Total amount paid for extraordinarily high cost, in addition to the DRG payment
Pass-Through Amount	Total reimbursement for certain high-cost items, such as transplant donors and blood factors, for which the actual or higher cost is passed through to the payor
Reimbursement Type	Reimbursement type
Short Stay Outlier Payment	Payment amount if stay is equal to or less than the Low Day Trim
Total Reimbursement	Total expected reimbursement on the claim
Transfer Payment	Payment amount if UB has a transfer discharge status; in place of DRG Inlier payment