OBJECTIVE: This article provides the information about pre-billing and instructions on how to identify, correct, and bypass pre-billing exceptions as well as how to update billing service codes in HHAeXchange.
Pre-Billing Exception Overview
|A visit with an EVV confirmation that falls outside of the specified tolerance range.
|The visit was only partially confirmed or not confirmed at all. Visits with this validation violation will need to be fixed on the Call Dashboard exception page.
|With TEMP Caregiver
Visits that have a TEMP Caregiver assigned to them. These calls are stored in the Call Dashboard but not synced to the visit.
To correct, the TEMP Caregiver must be replaced with the actual Caregiver.
|Visits that have validated the POC Compliance settings for that contract. All duties must be marked as Complete, Not Complete, or Refused.
|The Patient has no authorization or not enough hours in their authorization to cover the visit.
|Visits that have overlapping confirmations (shift of Caregiver).
There are three (3) ways to manage visits that land in pre-billing:
- Do nothing - Incomplete Confirmation (unable to confirm before weekly deadline)
- Assign Non-Billable Service Code
- Correct the visit - Add the Caregiver, correct the clock-in/out times if they're out of tolerance range or overlapping other shifts, and add or correct duties to meet POC compliance.
If authorization is currently unavailable but an authorization is needed to schedule a visit, a non-billable service code can be added to those visits. This will allow visits to bypass pre-billing to pay the Caregiver.
Non-Billable Service Codes
Refer to the following article to add or remove a non-billable service code: HHAeXchange: Non-Billable Service Codes
Source: HHAeXchange Support Center; HHAeXchange Enterprise Help Portal