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Attachment BOMB Control Number: 09381148Outpatient Hospital UP Guidance
I. The basis of the UP formula is:Contrasted Demonstration (e.g. Costtocharge ratio X Medicaid covered O/P charges) or
PaymentBased
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What is viii - oformr inpatient?
VIII - OFormR Inpatient is a form used to report inpatient medical services provided by healthcare facilities.
Who is required to file viii - oformr inpatient?
Healthcare facilities that provide inpatient medical services are required to file VIII - OFormR Inpatient.
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VIII - OFormR Inpatient is filled out by documenting the details of inpatient medical services provided, including patient information, diagnosis, treatment, and billing.
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The purpose of VIII - OFormR Inpatient is to track and record inpatient medical services for billing and reporting purposes.
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Information such as patient details, diagnosis, treatment provided, dates of service, and billing information must be reported on VIII - OFormR Inpatient.
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