Use this procedure to view the Pysch Inpatient Medicare Calculator results.
Procedure
- Access the Inpatient Medicare Calculator (Psych) results.
- Select Go To > Government Payor Research > Medicare > Inpatient Calculator. The Medicare Inpatient Calculator page opens.
Note: If your facility offers only one type of Medicare inpatient services, the system bypasses this selection page.
- Select Psych from the Type of PPS list and click Next. The Inpatient Medicare Calculator (Psych) page opens
- Select the appropriate criteria and click Calculate. The Inpatient Medicare Calculator (Psych) results page opens. For more information about the calculation criteria, refer to Use the Psych Inpatient Medicare Calculator.
- Select Go To > Government Payor Research > Medicare > Inpatient Calculator. The Medicare Inpatient Calculator page opens.
- View the calculation results.
- Click a link in the reimbursement table to display the step-by-step calculation details for a specific value.
Field Descriptions
The following table describes each of the fields on the Medicare Inpatient Calculator (Psych) page.
|
Field |
Description |
|
Covered Charges |
Amount of charges covered by Workers’ Compensation or Medicare |
|
Covered Days |
Number of covered days |
|
Federal Payment |
Dollar amount the federal government will pay for the care |
|
Hospital Payment |
Hospital-Specific Payment; that portion of the total payment that is “cost-based” rather than “prospectively priced.” Also see Hospital-specific Payment. |
|
Outlier |
Total amount of extraordinarily high cost services paid by Medicare |
|
Reimbursement Type |
Reimbursement type, either expected reimbursement or RA, if applicable (the latest RA is shown if there are multiple RAs) |
|
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 |