Services Included in Your MRF

Turquoise automatically determines which services appear in your final MRF based on the files you provide.

Chargemaster-Driven Inclusion

All services present in your institutional (and professional chargemaster if applicable) will be evaluated for inclusion. This includes charges found in standalone pharmacy, supply, laboratory, etc. files

Soft Coded CPT or HCPCS Codes

Turquoise supplements items found within the CDM with soft coded HCPCS/CPT codes based on historical claims data.

DRGs, PCS, EAPGs, etc.

When contracts leverage soft coded qualifiers like a DRG, PCS code, EAPG, etc., Turquoise will supplement the items found within the CDM with the applicable codes.

Reasons a Service May Be Missing

• Hard coded charge is not present in the chargemaster or supplemental charge files
• Soft coded HCPCS/CPT charge is not found within the last 12 months of claims data
• No negotiated rate for a given code in any payer contract provided