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Our Pt Financial Services analyst has come up with a solution for us.
Dee Ramirez
Delnor-Community Hospital
(630) 208-4251
-----Original Message-----
From: Mitchell Wallace
Sent: Monday, October 02, 2006 8:58 AM
To: Deanna Ramirez
Subject: RE: [MEDITECH-L] Reimbursement Management-Illinois Inpt
Medicaid
Hi Dee
I have done this, I'll do my best to explain
The second line of code in the rule is unnecessary, this can be combined
with line 1 for more efficient code.
With regard to the HCPC section, you can set this up using the MAGIC
CODE method in the Reimbursement Management dictionary
Starting on page 11.
You have to indicate the HCPC codes you want to reference by associating
them to the corresponding procedure code in the chargemaster dictionary
Then you associate a unique variable to each procedure code which it
looks like you have done but you are using the same variable over and
over.
Example:
Exceptions:
Procedure Temp Chg Cat
4202024 G2
4202032 G4
4202040 G2
4202057 G6
4210001 G1
Once this has been created you can reference this using magic code as
follows:
(/CHG["G1"]N)*13.30^X1
(/CHG["G2"]N)*34.87^X2
(/CHG["G4"]N)*23.56^X3
(/CHG["G6"]N)*12.21^X4
(/CHG["G7"]N)*40.63^X5
(/CHG["G8"]N)*71.72^X6
Additionally, Line #10 will not work for adjusting money if you are
prorating INS1 - the variable ADJ2 will adjust money if there is a
balance in the secondary Insurance.
Hope this helps.
Mitch Wallace
Systems Analyst, PFS
Delnor Community Hospital
mailto:[EMAIL PROTECTED]
-----Original Message-----
From: Deanna Ramirez
Sent: Monday, October 02, 2006 1:28 AM
To: Mitchell Wallace
Subject: FW: [MEDITECH-L] Reimbursement Management-Illinois Inpt
Medicaid
Hi,
I'm posting this for a co-worker.
I am looking for any Illinois Hospital that has set-up their Medicaid
Inpatient Adjustments using Reimbursement Management.
I have Reimbursement magic code that I have written but I do not know of
any coding that will look at the HCPCs code of charges in Reimbursement
Management. Following is the coding I have created. Where the NN
exists in the coding is were I would like the system to look at the
charges and see if there is a charge with the HCPC code I have
specified. I opened a task with Meditech many months ago. They have
looked at the task but I haven't received a resolution. If there is
anyone out there willing to share what they have done or has any
suggestions, I would greatly appreciate any feedback.
Coding:
1
TOT-/CHG["990PC"]-/CHG["991PC"]-/CHG["992PC"]-/CHG["993PC"]-/CHG["994PC"
]^T1
2 T1-/CHG["995PC"]-/CHG["996PC"]-/CHG["997PC"]-/CHG["998PC"]-
/CHG["999PC"]-/CHG["3
51CTSP"]^INS1
3 IF{TOT>20000 TOT^/FLG["MDIPOVER20"]}
4 DAYS*535.35^T2
5 INS1-/CHG["981ERDR"]^T3
6 IF{NN="99282" 24.20;0^T4}
7 IF{NN="99283" 32.20;0^T5}
8 IF{NN="99284" 44.00;0^T6}
9 IF{NN="99285" 69.25;0^T7}
10 /CHG["981ERDR"]-(T4+T5+T6+T7)^ADJ2
11 IF{NN="99284"!"99285" 181.00^T8}
12 IF{NN="99283"!"99282" 67.00^T9}
13 T3-(T2+T8+T9)^ADJ1
Line Item Description:
1 PATIENT CONVENIENCE CHARGES TO SP
2 PATIENT CONVENIENCE CHARGES TO SP
3 FLAG CONCURRENT REVIEW IF TOT OVER 20000
4 $535.35 PER DAY OF STAY
5 REMOVE ER DR CHARGES FROM INS1
6 HCPC 99282 $24.20
7 HCPC 99283 $32.20
8 HCPC 99284 $44.00
9 HCPC 99285 $69.25
10 ERDR CHARGES - (HCPC TOTALS) TO ADJ2
11 HCPC 99284 OR 99285 $181.00
12 HCPC 99283 OR 99282 $67.00
13 (TOTAL CHGS - ERDR)-($535.35/DAY+HCPCS)TO ADJ 1
Any help would be appreciated.
Thanks.
Janet Duback
MIS Clinical Coordinator
Community Hospital of Ottawa
Ottawa, IL 61350
815-431-5504
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Dee Ramirez
Delnor-Community Hospital
(630) 208-4251
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Janet Duback
Sent: Thursday, September 28, 2006 3:31 PM
To: MeditechL
Subject: [MEDITECH-L] Reimbursement Management-Illinois Inpt Medicaid
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