I am looking for some information about the AMT*B6 segment and charges in the 835 remit transactions. I have a few questions that I would greatly appreciate any feedback on:
1 - Are payers always required to report the allowed amount, or is this just for use with bundling or some set of curcumstances? 2 - What should be reported as the "allowed amount"? If there are $100 in charges, that are going to all be denied due to no referral, should the payer report what they would have allowed, or shoulf they report $0? Is there a clear rule on which they should report? 3 - When reporting charges when the payer is secondary, should they report the original charges, or just the portion they are covering? What should be the allowed amount under this situation? We are seeing different approaches to these issues between payers and are hoping to find a "standard" way these should be reported. Thanks for your help! -Chris Healy Dartmouth-Hitchcock Medical Center PFS-Billing Support Mgr 603-650-3730
