General Question for the Week of December 18, 2017

General Compliance Question of the Week

Question:

In the inpatient and outpatient charge data, what is the difference between “average charges” and “average total payments”?

Answer:

“Average charges” refers to what the provider bills to Medicare. “Average total payments” refers to what Medicare actually pays to the provider as well as co-payment and deductible amounts that the beneficiary is responsible for and payments by third parties for coordination of benefits.

 

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.