Questions & corrections

Northeastern Health System Sequoyah · Emergency dept visit low mdm

$360.00

Source file dated 2026-02-10 · both

Source note: This algorith calculates based on a base rate multiplied by the EAPG weight as defined by the payer multiplied by outpatient units of service and finally multiplied by a discount percentage which is defined under specific circumstances in the contract.|Recurring Services - not greater than 75% of charges for covered recurring services - adjust formula acordingly.| If multiple EAPGs are billed, the highest weighted is reimbursed at 100%, the next highest at 50%, 25% for all others and the totals per EAPG are added together. |For non-packaged EAPGs, they are ordered based on type and descending weight and use the Discount Percentage Matrix to apply percent.|If service is cancelled after being taken to room and prepped but before Anesthesia then 50% maximum reimbursement, if after anesthesia then 100%