How to Run the Report
From Barnestorm Office > Reports > Billing > 15.16 PPS Cost Report Summary.
- From / Thru = Selects episodes based on the Thru date.
- Program(s) = Filter report by entering program number(s). Or leave blank to select all.
- Paid Episodes Only = Check this box if you only want to select episodes with a zero balance. If unchecked, it will select episodes where the EOE has at least been created but does not need to be paid.
- Detail = Shows each episode, including what type of episode it is,how many visits, charges and amount paid.
- Summary = Gives count by payment type.
- ProRated Across the Thru Date = Gives you a list of patients that crosses the year, including the amount and numbers of days per year.
- All or County Code = Select All to print ALL episodes or select episodes for only one county code.
- Select Medicare Only payers, or Non-Medicare Only PPS Payers, or Both.
How to Read the Report
Detail:
- LUPA = Episodes that have four or fewer visits total will be marked as Y.
- PEP = Episodes paid as a PEP will be marked as Y.
- Outlier = Episodes paid as Outlier will be marked as Y.
- HIPPS = Calculated HIPPS based on actual visits.
- CBSA = Patient’s county code.
- Visits = Number of chargeable visits.
- $Charges = Total charges based on the job code rate (Codes >Rates > Job Codes).
- $Paid = Shows the amount paid for that episode. If zero amount then the EOE has not been paid yet.
Summary at the end of the report:
- CBSA = County code.
- #Episodes = The number of episodes in that county code for the selected time frame.
- SN / PT / OT / ST / MSS / HHA / Total = The number of episodes that each discipline was involved in, per county code.
________________________________________________________________________________________________________
Summary:
- Description = Discipline and type of episode description.
- The next six columns shows each type of episode. The discipline visits are the number of chargeable visits; the discipline charges are the amount from the job code(Codes > Rates > Job Codes).
- Totals = Adds up each row.
_________________________________________________________________________________________________________
ProRated Across the Thru Date:
- HIPPS = Calculated HIPPS based on actual visits.
- From date / Thru Date = Episode dates.
- $Amount = Paid amount, calculated amount or RAP amount (depending on status of episode). The $amount comes from:
if paid, the amt paid;
if not paid, the estimated value;
if no estimated value, the HIPPS $amt
- Thru = Prorates the $Amount based on the number of days between the episode from date and the report thru date, divided by the total number of days in the episode in the episode.
- After = Prorates the $Amount based on the number of days between the day after the report thru date and the episode and end date, divided by the total number of days in the episode.