Tip: Pharmacy Out-of-pocket amounts
Number | 0049 |
|---|---|
Submitting Entities | All entities submitting pharmacy data |
Add Date | Mar 12, 2020 |
Update Date |
|
Update |
|
Description | The amount found in Member total out of pocket (PC069) has been found to be incorrect on some submitted records |
Action / Resolution | Calculate Member total out of pocket instead of using PC069. Calculation: Sum co-pay amount (PC040), co-insurance (PC041), and deductible amounts (PC042). |
Category 1 | Misc |
Category 2 | Out-of-Pocket Cost |
Tip / Issue | Tip |