Use this procedure for the Acute Inpatient Medicare Calculator.
Procedure
- Access the Inpatient Medicare Calculator (Acute) page.
- Select Go To > Government Payor Research > Medicare > Inpatient Calculator. The Medicare Inpatient Calculator Selection page opens.
Note: If your facility offers only one type of Medicare inpatient services, the system bypasses this selection page.
- Select Acute from the Type of PPS list and click Next. The Inpatient Medicare Calculator (ACUTE) page opens.
- Select Go To > Government Payor Research > Medicare > Inpatient Calculator. The Medicare Inpatient Calculator Selection page opens.
- Specify the calculation criteria and optional values. For more information about each calculation criteria, refer to the Field Descriptions table below.
Note: All patient identification information is required.
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(Option) Click Overrides to access the Optional Values popup window. From the Option Values window, you can do any of the following:
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Select Apply Sequestration Reduction check box so that the calculator uses this option (default is unchecked)
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Select Apply HAC Reduction check box so that the calculator uses this option (default is unchecked)
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Click OK to save your selections or click Cancel to return back to the previous page.
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- Click Calculate. The Inpatient Medicare Calculator (ACUTE) results page opens. For more information, refer to View the Acute Medicare Inpatient Calculator Results.
Field Descriptions
The following table describes each of the fields on the Medicare Inpatient Calculator (ACUTE) page.
|
Field |
Description |
|
Bill type |
|
|
Billed Charges |
Total charges for the account |
|
Condition Codes |
A two-digit code identifying a condition that affects processing and payment of the claim. Note: Condition codes indicate whether coverage exists under another insurance, whether the injury or illness is related to employment, whether the bill is an outlier, or if medical necessity affects room assignment. |
|
Discharge Date |
Date patient was discharged; defaults to the current system date. If you enter a specific discharge date, the results are displayed for the closest date available (from data within the system). |
|
Patient’s destination upon discharge (home, LTC, and so on) |
|
|
DRG |
Diagnosis Related Group code |
|
Hemophilia Factor & Organ Acquisition Charges |
Extra charges for the cost of obtaining organs for transplant (if any) |
|
Length of stay |
Length of stay, in days |
|
Non-Covered Charges |
The amount of non-covered charges (not disallowed charges) |
|
Per Diem Passthrough Amount |
The amount of Medicare Bad debt, Organ acquisition excluding Corneal, and/or Direct graduate medical education. |
|
Provider Number/NPI |
Provider’s tax ID number or ten-digit National Provider Identification (NPI) number required on all claims |
|
Overrides (click to view Optional Values) |
|
|
Apply Sequestration Reduction |
Click the Apply Sequestration Reduction check box so that the calculator uses this option (default is unchecked) |
|
Apply HAC Reduction |
Click the Apply HAC Reduction check box so that the calculator uses this option (default is unchecked) |