what is the payment formula used to calculate ky medicaid payments
The EOB will list information such as the provider's billed amount, the amount the insurance company allowed, and the amount the insurance company paid. This information is used to calculate the secondary payer allowed amount (SA), the secondary payer paid amount (SP) and the obligated to accept field (OTAF) amounts. The method of calculating the Medicare secondary amount is the same whether the claim is assigned or unassigned.