When reporting patient responsibility dollars assumed by an HSA or FSA account in the CAS segment, when the funds in the HSA are insufficient, the entire amount is non-covered, which of the following would be appropriate given the following criteria:
Charge $1500.00
Provider discount 375.00
Patient liability (Deductible) 650.00
Payment from PSA 475.00
CLP*xxxxxxxxxx*1*1500*475*650*12*2011xxxxxxxxxxxxx~
CAS*PR*187*-475**1*1125
OR
CLP*xxxxxxxxxx*1*1500*475*650*12*2011xxxxxxxxxxxxx~
CAS*PR*187*-475**1*475~
Perhaps another more accurate method could be suggested. thanks.
If we are interpreting the PSA amount correctly the this is how it should be reported.
Charge $1500
Provider discount $375
1500 - 375 = 1125 (Pt Liab - Ded - PR1)
Of the $1125 (PR1), the HSA pays $475 (neg. PR187) reducing the $1125 Pt Resp. to a final (net) Pt Resp amount of $650. (CLP05)
CLP*XX*1*1500*475*650*12*9999999999~
CAS*CO*45*375~
CAS*PR*1*1125**187*-475~
If we've misinterpreted your question or your scenario feel free to re-inquire.