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Data Element Name:  Expected Reimbursement Other 1 File Location:   Master, De-Identified, De-Identified Abbreviated
SPARCS Data Element Number:  29
Record Positions:  146 - 147 Format-Length:  A/N - 2
Effective Date:  1/1/1994 Revision Date:             
Deniable Data Element:  No

Definition:

The code which identifies secondary source of payment which is expected to pay some part of the hospital bill.

The Medicare and Medicaid HMO payer codes were used when the HMO responsible for payment received the reimbursement from one of the respective payers for the patient. If this information was not available from the patient's insurance card or from the admittance interview, the Other HMO payer code was used.

Codes and Values:
  1. Must have been a valid code in accordance with the Expected Reimbursement Codes in Appendix D.

  2. If this field was not applicable it must have contained blanks.
Edit Applications:
  1. Must have been a valid entry.