Ohio Cost to Charge Ratio Changes for 2012
Post date: Jun 19, 2012 12:57:38 PM
The Ohio BWC has changed the Cost to Charge Ratio tables as of 02/01/2012 for inpatient bills and 04/01/2012 for outpatient bills. The methods of determining the Cost to Charge Ratio values and the new tables are attached below. In order to use these new methods and tables it is now necessary for the user to input the NPI number (box 56 on UB04) for the provider in addition to the provider's EIN. If the NPI number is not entered into the bill reduction screens the system will use the default reductions for inpatient and outpatient services. The cost to charge or default reduction percentage will be shown in the CCR field on the bill reduction screens.
When paying inpatient and outpatient bills with dates of services prior to this change, it is still required to enter the 11 digit BWC provider number (EIN + 2 digits) into the first field on the bill reduction screens to have the system find the proper Cost to Charge Ratio values to reduce the bill.