Question:
What information is included in the private-payer claims data for (PAMA) reporting?
Answer:
The following applicable information should be part of the private-payer claims data under the Protecting Access to Medicare Act of 2014 (PAMA):
- Laboratory tests subject to the data-collection and reporting requirements
- Final amount paid by a private payer for laboratory tests after all private-payer price concessions are applied
- Payments from secondary insurance payers
- Any patient cost-sharing amounts, if applicable
- Multiple payment rates for the same test.
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