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* paid_by_primary does contribute to the total_paid variable. The paid_by_primary field is only used for reporting a patient's primary insurance payment amount reported on the secondary payer insurance claim. If the source data has actual primary insurance payments (e.g. the primary insurance payment is not a derivative of the payer claim and there is verification another insurance company paid an amount to the provider), then the primary insurance payment should have its own cost record with a payer_plan_id set to the applicable payer, and the actual primary insurance payment should be noted under the paid_by_payer field. | * paid_by_primary does contribute to the total_paid variable. The paid_by_primary field is only used for reporting a patient's primary insurance payment amount reported on the secondary payer insurance claim. If the source data has actual primary insurance payments (e.g. the primary insurance payment is not a derivative of the payer claim and there is verification another insurance company paid an amount to the provider), then the primary insurance payment should have its own cost record with a payer_plan_id set to the applicable payer, and the actual primary insurance payment should be noted under the paid_by_payer field. | ||
* revenue_code_concept_id: Revenue codes are a method to charge for a class of procedures and conditions in the U.S. hospital system. | * revenue_code_concept_id: Revenue codes are a method to charge for a class of procedures and conditions in the U.S. hospital system. | ||
+ | * drg_concept_id: DRG is a system to classify hospital cases into one of approximately 500 groups for reimbursement purposes. They have been used in the United States since 1983. | ||