Scheduled Change Sets

When a change is needed in your configuration, a Scheduled Change Set can be created to establish an effective date for those changes and prevent unnecessary claim corrections.

User Permissions

Only users with admin-level permissions can access and configure change sets in the Practice Admin. For more information on user profiles and permissions, click here.

What Areas In The RCM Use Scheduled Change Sets?

There are three areas in the RCM where a scheduled change can be created, the majority of which are located in the Practice Admin.

• Only admin-level users can create and manage change sets in the following areas of the Practice Admin. For more information on user profiles and permissions, click here.
  Practice Admin > Configuration

  • Insurance Billing + Pay-To
  • Insurance Payers
  • Expected Rates
  • Services
  • Services > Service Billing Profiles
  • Rendering Providers

  Practice Admin > Facilities

  • Facility Profile
  • Facility Rates
  • Facility Rendering Providers
• The Patient Billing section is the only part in the Organization Admin that uses change sets. Only Managing Organization or Organization admin-level users can create and manage change sets in the Organization Admin section of the RCM. For more information on user profiles and permissions, click here.
• The Claim Rules section of the Management Center uses change sets to ensure that changes made to an individual rule will apply only to a select number of claims. Only Managing Organization Admins can create and manage change sets for claim rules. For more information on user profiles and permissions, click here.

Baseline vs. Scheduled Change Set

Use the following information to determine whether to update the Baseline information or create a Scheduled Change Set.

• If you need to make a change that will affect all existing claims, change the Baseline.
• If we need to make a change that will only affect existing claims through a certain date, create a Scheduled Change Set for that effective date. 
• If we need to make a change that will affect only future claims, create a Scheduled Change Set with a future effective date. 

Create a Scheduled Change Set

Let's review how to create a Scheduled Change Set!

1. When a change is needed, navigate to the item in question and click the Create Scheduled Change Set button.
   
2. Enter the Effective Date, then click Save.
3. Next, click the pencil icon on the Scheduled Change Set Date to open the edit window.
4. Make the desired updates, then click Save to complete the process.
   

Frequently Asked Questions and Helpful Hints

Let's review some FAQS and helpful hints about Scheduled Change Sets!

Frequently Asked Questions

• Some of the most common uses for this feature are updating expected rates when a contract renews at the beginning of the year, updating the Insurance Billing address for a planned move, and deactivating rendering providers who plan to leave the facility in the near future.
• Let's say a scheduled change is created to change the bill-type prefix with an effective date of 05/01/2026 and the patient's submitted claim spans 04/28/2026-05/07/2026.
  
  Since the system now has two different bill-type prefixes for the claim, it will attempt to generate corrections by splitting the existing claim. It does this by removing the DOS that occurred on/after the effective date (05/01/2026) from the original claim and creating a new one.
  
  This means the system will attempt to generate a new claim to bill the previously removed DOS (05/01/2026-05/07/2026) and send it to the payer. Both corrections will need to be generated and submitted to the payer to ensure all DOS are accounted for and reimbursed.
• If a change set is generating unwanted corrections, we recommend using the ignore feature to dismiss them from the Work Center. If the dismissed corrections need to be created later, follow the instructions outlined here.
• To help determine if a scheduled change is causing claims to split, we first recommend comparing the two claims and identifying any differences in information between them. If you are unable to determine what occurred based on the difference in information, note the exact date the claims split, then generate a User Audit Report using a date range that goes back at least 3 months and set the ScheduledChangeSet as the Object Type.

Helpful Hints

• It is advisable to schedule a change set in advance to prevent disruptions to existing claims. If corrections are needed for claims already submitted, we should evaluate how the selected effective date will impact claims, such as splitting service dates or applying claim rules.