Release Notes:
Data Element
Version 2012B
| Data Element Name: | Payment Source |
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| Collected For: | All Records , Optional for HBIPS-2 and HBIPS-3 |
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| Definition: | The source of payment for this episode of care. |
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| Suggested Data Collection Question: | What is the patient's source of payment for this episode of care? |
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| Format: | | Length: | 1 |
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| Type: | Alphanumeric |
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| Occurs: | 1 |
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| Allowable Values: |
1 Source of payment is Medicare.
2 Source of payment is NonMedicare.
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| Notes for Abstraction: |
- If Medicare is listed as the primary, secondary, tertiary, or even lower down on the list or payers, select "1".
- If the patient has Medicaid only or Medicaid and another insurance type, other than Medicare, select "2". If the patient has Medicaid and Medicare, select "1".
- If the patient is an Undocumented Alien or Illegal immigrant select "1". Undocumented Alien: Section 1011 of the Medicare Modernization Act of 2003 allows for reimbursement for services rendered to patients who are: Undocumented or illegal aliens (immigrants), Aliens who have been paroled into a United States port of entry and Mexican citizens permitted to enter the United States on a laser visa.
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| Suggested Data Sources: |
- Face sheet
- UB-04, Field Location: 50A, B or C
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| Additional Notes: |
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| Guidelines for Abstraction: |
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| Inclusion | Exclusion |
Medicare includes, but is not limited to:
- Medicare Fee for Service (includes DRG or PPS)
- Black Lung
- End Stage Renal Disease (ESRD)
- Railroad Retirement Board (RRB)
- Medicare Secondary Payer
- Medicare HMO/Medicare Advantage
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Payment Source
Specifications Manual for Joint Commission National Quality Measures (v2012B)
Discharges 07-01-12 (3Q12) through 12-31-12 (4Q12)
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