Here at Harvard Pilgrim we are encountering a problem where some Medicare
(HCFA)hospital DRG claims are being paid with $0.00 when they are re-
adjudicated through the HSS pricer module.   They are grouping fine.

The claim has:
- a DRG value in the claim header (returned from the HSS grouper)
- a HCFA pay code(09) on at least 1 of the service lines (usually on line
100)
- payable status (not denied).

It seems as though the AMTPAY field on DRG hospital claims claims is being
zeroed out when the claim goes through batch readjudication, BCP0500.  We
know that the claim has the proper AMTPAY before batch adjudication, then
once it is run through batch readjudication (which includes HSS
Grouper/Pricing processing), the AMTPAY values are zeroes out.  We suspect
that the HSS processing has something to do with this problem, but we can
not recreate the problem in our test environment - perhaps there is a
contention issue with the HOSPRATE and/or DRGRATE KSAM files.

Has anybody encountered anything like this?
Any feedback or theories will be appreciated.

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