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Create Financial Class

 
Use this page to create a new financial class.
 
Financial classes are used to control the grouper and pricer settings used during coding and auditing operations as well as determine if the chart should use ICD-9 or ICD-10 DX and PRX codes. It also determines if the chart will have an MS-DRG or APR-DRG.
 
Create Financial Class
 
 
1

Name

1. Name
Set the name of the financial class here. During import of encounters, any encounters imported into this facility that match this financial class name will use these settings on import.
2

Group

2. Group
Set or select a group that this financial class is a part of. If an appropriate one doesn't exist in the dropdown, just type the name of a new group.
 
If you want to create a financial class that uses the same settings as an existing one, select the group the original exists in and click the Copy from Group button. Those group settings will immediately be applied to the new financial class.
3

Coding System Selection

3. Coding System Selection
Select whether the financial class is for ICD-9 or ICD-10.
4

Inpatient Grouper Selection

4. Inpatient Grouper Selection
Select the inpatient grouper type here.
 
The possible options are:
  • CMS
  • APR
  • AP
  • TRICARE
  • Maryland Payment with APR DRGs
  • APR DRG with New York Psych
5

Grouper Version Selection

5. Grouper Version Selection
Choose the grouper version that you want to use for reimbursement calculation.
 
These are dynamically pulled in from TruCode, therefore the latest version that is available is always selectable.
6

Inpatient Pricer Type Selection

6. Inpatient Pricer Type Selection
Select the inpatient pricer type here.
 
The possible options are:
  • Medicare IPPS/Medicare Managed Care​
  • ​Maryland APR Case Mix Weights​
  • ​TRICARE​
  • ​APR Weights and Trims​
  • ​CMS Long Term Care
  • CMS Psychiatric​
  • ​Mississippi Medicaid
  • ​Maryland Payment with 3M APR DRGs​
  • Illinois Medicaid - APR​
  • ​New York Medicaid - APR
  • ​New York Medicaid Managed Care - APR​
  • ​New York Worker's Compensation - APR
  • ​New York No-Fault - APR​
7

Pricer Value

7. Pricer Value
Field for adding a custom pricer value.
Currently not used.
8

APR Options

8. APR Options
Various APR pricer options.
 
Most APR scenarios should select Use APR Admit Logic, Use CMS HAC Logic, and Simple Pricing.
9

APR Base Rate

9. APR Base Rate
Set the APR base rate here. Defaults to $5000.
The APR DRG reimbursement amount is calculated as weight * APR base rate.
10

Cost Outlier Payments Flag

10. Cost Outlier Payments Flag
Set cost outlier payment flag.
Currently not used.
11

Outpatient Grouper Selection

11. Outpatient Grouper Selection
Select the outpatient grouper here.
 
The possible options are:
  • OCEAPC
  • ASC
12

Outpatient Pricer Selection

12. Outpatient Pricer Selection
Select the outpatient pricer here.
 
The possible options are:
  • CmsApc
  • CmcAsc
13

Days Allowed to Rebill

13. Days Allowed to Rebill
Set the number of days after completion of an audit that the client is allowed to rebill. A message will display in all post-audit views until this date has been passed indicating how long until the countdown expires.
14

Create Button

14. Create Button
Click this button to save the new financial class to the database.
15

Copy from Group Button

15. Copy from Group Button
Click this button to copy the settings from the selected group to the new financial class.
16

Back to List Link

16. Back to List Link
Follow this link to return to the financial class index.