Wisconsin

The reimbursement rate is calculated using the base weight (determined by the state Medicaid) and the contract values entered in this node.

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%.

The following table describes the fields on the WI tab of the Medicaid - Facility reimbursement tool.

Field	Description
Override Provider Number	Not available at this time.
Override Service Date	Not available at this time.
State Code	This field defaults to WI, 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.