Magnolia Shoppable - Freedom Behavioral

facility	tax_id	update_date	version
beacham-memorial-hospital	811097331	4/1/2023	1.0.0

SERVICE DESCRIPTION	CATEGORY	BILLING MSDRG \| CPT \| HCPCS	ITEM/SERVICE DESCRIPTION	BILLING REVENUE CODE	GROSS CHARGES	Medicare	REIMBURSEMENT METHOD	Humana	REIMBURSEMENT METHOD	Aetna	REIMBURSEMENT METHOD	Cigna Behavioral Health (Commercial)	REIMBURSEMENT METHOD	Allwell	REIMBURSEMENT METHOD	BCBS of Mississippi	REIMBURSEMENT METHOD	Ambetter	REIMBURSEMENT METHOD	Advance Health System	REIMBURSEMENT METHOD	Wellcare (Harmony Health Plan)	REIMBURSEMENT METHOD	United Healthcare/UBH	REIMBURSEMENT METHOD	Molina	REIMBURSEMENT METHOD	Mississippi Physician Care Network	REIMBURSEMENT METHOD	Magolia Health	REIMBURSEMENT METHOD	Equian	REIMBURSEMENT METHOD	Optum VACCN	REIMBURSEMENT METHOD	Vantage	REIMBURSEMENT METHOD	De-Identified Minimum Negotiated Rate	De-Identified Maximum Negotiated Rate	DISCOUNTED CASH PRICE
Inpatient	Inpatient Psychiatric Services		Inpatient Psychiatric Service	N/A	Base Rate	IPF PPS	Per Diem	850	Per Diem	900	Per Diem	800	Per Diem	IPF PPS	Per Diem	769	Per Diem	N/A	N/A	769	Per Diem	IPF PPS	Per Diem	800	Per Diem	N/A	N/A	835	Per Diem	N/A	N/A	IPF PPS	Per Diem	N/A	N/A	$1,000.00	Per Diem	$769.00	$1,000.00	900
Inpatient	Inpatient Acute Care Inpatient Hospitalization			N/A	Base Rate	DRG-MCR	MS-DRG	DRG-MCR	MS-DRG	DRG-MCR	MS-DRG	DRG-MCR	MS-DRG	DRG-MCR	MS-DRG	1425	Per Diem	908	Per Diem	1155	Per Diem	DRG-MCR	MS-DRG	N/A	N/A	MCD RATE	MS-DRG	1200	Per Diem	DRG-MCR	MS-DRG	DRG-MCR	MS-DRG	DRG-MCR	MS-DRG	DRG-MCR	MS-DRG	$769.00	$1,425.00	1200