Banner Health calculates the Amounts Generally Billed (AGB) for each hospital utilizing the “look-back” method. The AGB is derived by dividing the sum of all claims for services provided in the relevant period allowed by Medicare fee-for-service and all private insurance including patient portions whether the amounts were paid or not, by the gross charges for such medically necessary services. The relevant period is defined as the 12-month period beginning October 1 and ending on September 30.
The Hospital-Specific AGB Percentage shall be calculated for the relevant period no later than November 14th of each year, for the most recently completed relevant period. Each Hospital-Specific AGB Percentage will be effective until the next annual calculation the Hospital-Specific AGB Percentage. The calculation of the Hospital-Specific AGB Percentage for each Hospital shall comply with the “look-back method”.
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