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CO HCPF Inpatient/Outpatient (IP/OP) Billing Manual — Third-Party Payment Prorate

Third-PartyPaymentProrate

activein force · 2026-07-26 – presentas-observed

Whenaproviderreceivesathird-partylumpsumpaymentformultipleservicesbilledtoHealthFirstColoradoonseparateclaimforms(e.g.,hospitalstayandtransportation),theprovidershouldproratethethird-partypaymenttothemultipleservices/claims.

Eachclaimmustincludeacopyoftheinsurancecompany'sExplanationofBenefits(EOB)orcheckwithanotationthatthepaymenthasbeenappliedtomultipleclaims.

Example(foroutpatientandtransportationservices):Servicesincurredwere:Outpatient$800Transportation$200TotalBilledtoThird-PartyPayer$1000Lump-sumpaymentreceivedfromThird-PartyPayer$700

Toproratethird-partypaymentformultipleHealthFirstColoradoUB-04institutionalclaims,determinewhatpercentageofthetotalchargeisrepresentedbyeachclaimamount.Divideeachindividualclaimchargebythetotalcharge.

OutpatientServices$800÷$1,000=80%TransportationServices$200÷$1,000=20%

Todeterminethecorrectthird-partypaymentamounttoenteroneachclaim,multiplyeachpercentagefromthepreviouscalculationtimesthetotalamountreceivedfromthethird-partypayer.

TheseamountsshouldbeenteredontheThird-PartyPayerlineinformlocator54(PriorPayments).

80%x$700=$560ontheOutpatientclaim20%x$700=$140ontheTransportationclaim

TheamountfortheHealthFirstColoradolineinformlocator55(EstimatedAmountDue)isthedifferencebetweenthetotalclaimchargeandthethird-partypayerprorateamount.

Outpatient$800-$560=$240Transportation$200-$140=$60

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Provenance

Source
hcpf.colorado.gov
Retrieved
2026-07-26
Edition
2026-07-26
Content hash
746cfd3f8578081a245e235ab795d5f8b683985ac5adfaed44b4b5e4d71e28f5
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CO HCPF Inpatient/Outpatient (IP/OP) Billing Manual — Third-Party Payment Prorate · binding.law