Tri-Service CHAMPUS Statistical Database Project (TCSDP). Department of ArmyHealth Services Command CHAMPUS Catastrophic Payments First thru Third Quarter, Fiscal Year 1992, Gateway Catchment Areas

摘要

This report presents in appendices B-D, separate CHAMPUS Catastrophic QuarterlyPayment Reports for the First through Third Quarters, Fiscal Year (FY) 1992. By quarter and then by each of the thirteen Gateway catchment areas reported, Privacy Act protected patient cases having CHAMPUS claims totaling more than the catchment area's specific catastrophic cutoff amount are listed along with the changes in their net claim payments between the reported and prior quarter. Each Payment Report includes the following for each patient: (1) the patient unique Inpatient Record Number; (2) the last hospital ending date on record; (3) the last hospital and professional services voucher payment dates; (4) an indicator of whether the case involved a consolidation of hospital stays due to FI adjudication action; (5) the DRG and diagnosis codes and their shortened names; (6) number of days spent in the hospital; (7) number of professional services; (8) patient age, sex and beneficiary category; (9) the catastrophic amounts above the site's specified catastrophic cutoff amount as of the first and last day of the reported quarter; and (10) the difference of these two catastrophic totals which equals the catastrophic net payment made for each patient during the quarter. Appendix A contains the three CHAMPUS Catastrophic Quarterly Payment Schedules and lists the summary totals of each catchment area's catastrophic amounts and number of cases from each applicable Payment Report, summing over all thirteen catchment areas for each quarter.