This variable is contained in the following files:
SAS Name
NCH_CLM_BENE_PMT_AMT
The total payments made to the beneficiary for this claim (sum of all line-level payments to beneficiary, variable called LINE_BENE_PMT_AMT).
Values: XXX.XX
Source: NCH QA Process
Comments
This variable is populated if, for example, a beneficiary pays for a service that should have been Medicare-covered.
The beneficiary can be refunded the payment.
Costs to that beneficiaries are liable for are described in detail on the Medicare.gov website. There is a CMS publication called "Your Medicare Benefits," which explains the deductibles and coinsurance amounts.
Medicare payments are described in detail in a series of Medicare Payment Advisory Commission (MedPAC) documents called “Payment Basics”.
This variable is populated if, for example, a beneficiary pays for a service that should have been Medicare-covered.
The beneficiary can be refunded the payment.
Costs to that beneficiaries are liable for are described in detail on the Medicare.gov website. There is a CMS publication called "Your Medicare Benefits," which explains the deductibles and coinsurance amounts.
Medicare payments are described in detail in a series of Medicare Payment Advisory Commission (MedPAC) documents called “Payment Basics”.
Also, in the Medicare Learning Network (MLN) “Payment System Fact Sheet Series”.