About grouping and pricing APC and eAPG claims

Many contracts include clauses or terms that include APCAmbulatory Patient Classification. In most cases, this is the unit of payment under the Outpatient Prospective Payment System (OPPS). or eAPGEnhanced Ambulatory Patient Grouping System provided by 3M. This system calculates pricing for outpatient hospital claims. reimbursement methods. Before these contracts can be calculated, the claim line items need to be grouped and priced into APCs or eAPGs.

Grouping and pricing can be a slow process when there are hundreds of thousands of claims, which is why claims processing is usually done during the nightly import. However, you may need to group and price claims on demand.

The Group and Price Claims page in the Claims section of Axiom Contract Management enables you to set up, save, and execute claim grouping and pricing tasks. Previously, all grouping and pricing took place either by a member of Client Success or during the nightly import process on claims coming into the system. Now you can run this process anytime on selected claims. For information, see Group and price APC and eAPG claims.

Additionally, you can also use the Shift Date By feature to view a forecast of how new schedules will affect claims for the coming year.