How to Run the Report
This report shows detailed information about each episode. From the Main Menu in Barnestorm Office click on Reports > Billing > 18.02 PPS HIPPS$ vs Expected$.
Program(s) / Team(s) = Filter report by entering program and/or team numbers. Or leave blank to select all.
From / Thru dates = Episodes dates. These dates tie into the option of From Dates or Thru Dates (bullet options).
EOE Billed Not Paid = Selects episodes where EOE was billed, not be paid.
Paid = Selects episodes where EOE was billed and the episode is at a zero balance.
When Paid is checked:
Show All Episodes = Will show all episodes
Skip Where Paid = Billed = If the Paid number and the Billed are the same they will not print.
Underpaid by = shows episodes underpaid by the percentage or less
Overpaid by = shows episodes overpaid by the percentage or more
From Dates = Selects the episodes based on the from date of the episode.
Thru Dates = Selects the episode based on the thru dates of the episode.
Medicare = Selects Medicare PPS episodes
Non-Medicare = Selects non-Medicare PPS episodes
Both = Selects both Medicare and non-Medicare payers.
How to Read the Report
From Date= The from date of that episode.
Thru Date = The thru date of that episode. This can be the discharge date or the last day of the 60-day episode if the patient was still active.
Pg/Pyr = The program and payer number.
HIPPS = The first HIPPS code shown is what appeared on the RAP, or the Amount Billed in A/R.
Vx = Total visits
Lu = LUPA threshold.
HIPPX = The second HIPPX code is the code after the episode was calculated for number of visits, Supplies, LUPA, etc…
$Expected = Shows the amount that Barnestorm has calculated and should be paid after allowing for Therapy, Supplies, LUPA adjustments.
The next four columns with $Diff show why the episode was paid differently. Other$Diff includes any other reason why the episode would be paid differently. The $Paid column only shows an amount when the episode is paid in full. It reflects what was actually paid.