Reimbursement Rate = Base Weight * Percent Reimbursement
Refer to the contract to determine the values to enter for the following required fields:
- Percent Reimbursement – Type the applicable percentage amount. The default value is 100%.
Field Descriptions
The following table describes the fields on the WA tab of the Medicaid - Facility reimbursement tool.
|
Field |
Description |
|
Override Provider Number |
Preferred provider number. Up to ten alphanumeric digits. |
|
Override Service Date |
Not available at this time. |
|
State Code |
This field defaults to WA, and it cannot be changed. |
|
Do not consume charges |
Provides the option not to consume charges. This is used for contract carve outs. |
|
Do not consume units |
Provides the option not to consume units. This is used for contract carve outs. |
|
Percent Reimbursement |
Three digit percentage amount. The default value is 100%. |
|
Cap line items at lesser of billed charges or Medicaid reimbursement |
Select this check box to allow line items to price the lesser of billed charges or Medicaid reimbursement. This option does not apply to inpatient or physician services. This check box is unchecked as the default. |
|
Price to zero on error |
Enable (check) this option to include accounts that fail to price due to an error display with an expected reimbursement amount of zero ($0). When this check box is disabled (not checked), accounts price to 100% of billed charges. |