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Borchiellini D, Etienne-Grimaldi MC, Thariat J, Milano G
Final action: After consideration of the comments received, we are finalizing at new 180.50(b)(2)(ii)(C)( 2 ) that if the payer-specific negotiated charge is based on a percentage or algorithm, the hospital must calculate and encode the total number of allowed amount remittances from the EDI 835 ERA transaction data or an alternative, equivalent source of remittance data used to calculate the median, 10th percentile, and 90th percentile allowed amounts
That documentation requirement is not a formality
10.1038/s41591-024-03015-5 Nat Med
Metabolism 72 , 117 (2017)
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