Remittance Advice Detail – Outpatient Medicare Accounts

The Remittance Advice Detail page displays some outpatient Medicare account information in the tables shown, as well as links to more information.

Click a link in the Service Date column to show which RA(s) includes that line item.
Each line item can be included in one, multiple or all RAs.

Field Descriptions—Outpatient Medicare Accounts

The following table describes the fields on the Remittance Advice Detail page for outpatient Medicare accounts. Some of the fields described below might not be displayed on your page. The appearance of fields depends on the type of the account currently showing. (Applicable if FinThrive reprices outpatient Medicare claims for your facility).

Field	Description
Actual Payments	The total insurance and patient payments posted to the accounts, as defined in the data
APC Codes	Ambulatory Payment Classification codes
APC Payments, excluding outliers	Total reimbursement by the Ambulatory Payment Classification, a set of payment rates based on groups of outpatient services rather than on individual services
Billed Units	Number of units billed
Charges	Amount billed by the provider
CPT/HCPC Codes & Modifiers	Associated CPT or HCPCS codes and modifiers
Fee Schedule Payment	Total reimbursement from a fee schedule (Lab, DMEPOS, PEN and therapies)
No.	Sequential reference number of the line item
Pass-through Payment	Total reimbursement for certain high-cost items like implants, high cost drugs and biologicals for which the actual or higher cost is passed through to the payor
Payment Codes	Used to explain the payment of the account; defined in the Remittance Payment Codes table
RA Claim Status	Explanation of the RA claim status code used in the Reimb. column
Reimbursement	Reimbursement type, either expected reimbursement or RA, if applicable (the latest RA is shown if there are multiple RAs)
Remittance Payment Codes	Explanation of the remittance payment code used in the Payment Codes column
Rev Code	Revenue code
Service Date	Date the service was rendered
Status Code	APC payment status code
Total Claim Outlier Amount	Total amount for extraordinarily high cost (cost outlier) for all service dates
Total Co-Payment	Patient’s copay
Total Medicare Payment	Total payment from Medicare
Total Payments, Including Outliers	Total amount from Medicare