Payment amounts not reconciling

[Jason Turan]

I've noticed that, for any "CARRIER" EOB Type, the line-level payments of what the member pays + what the provider pays never matches the Allowed / Total Paid amount. In fact, it's almost always a few dollars less. Is this perhaps related to the Medicare Sequestration Payment of 2%? Hopefully so, but I see many cases where the percentage difference is slightly less than 2% or slightly more than 2%. However, it's always close to 2%. If this isn't Medicare Sequestration, then is there another explanation? This variance is consistent across every patient's data I've seen so far.

Thanks,

Jason

[Jillian Theil]

Hi Jason,

Thanks for your question. We are consulting with our upstream data provider and will get back to you with an answer as soon as possible.

Thanks,
Jillian Theil
- The Blue Button 2.0 Team

[Jillian Theil]

Hi Jason -

Thanks for your patience as we looked into this further. Unfortunately, we are not experts in how the claims payments are calculated. Our focus is on providing the data to end users, so we are unable to give you a definitive answer to your question.  

Apologies we cannot be of more help on this particular question.

Best,
-The Blue Button 2.0 API Team