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Northern CaliforniaRegion Northern CaliforniaRegion

Northern CaliforniaRegion - PDF document

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Uploaded On 2021-09-25

Northern CaliforniaRegion - PPT Presentation

Amounts Generally BilledAmounts Generally Billed AGB is based on the lowest average of the amounts that were paid to a KP facility by private health insurers Medicare feeforservice and Medicaid feefor ID: 885432

generally amounts agb billed amounts generally billed agb based charges total claims feeforservice

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1 Northern CaliforniaRegion Amounts Gene
Northern CaliforniaRegion Amounts Generally Billed Amounts Generally Billed (AGB) is based on the lowest average of the amounts that were paid to a KP facility by private health insurers, Medicare feeforservice and Medicaid feeforservice (and copays and deductibles) for emergency or medically necessary services, based on actual claim data from November1, 201to October 31, 201, which is consistent with the lookback method. Total expected payment from allowed claims was divided by total billedcharges for such claims, and that number was subtracted from 1 to calculatethe AGB percentage. The 2019AGB reduction to gross charges is 57% for hospital charges.