If the desired corrections are not populating, or are not generating as desired, run through the following steps.
- Run through the steps to generate the correction again. Verify that everything was completed correctly and no steps were missed.
- Check the Corrections History for corrections that were ignored previously.
- This is where corrections go when the Ignore radio button is selected on the Select Correction Action form.
- You can View and Update corrections from this tab.
- Check the patient's other Treatment Episodes. If the patient has multiple treatment episodes, the corrections may be in a different episode than the one you're currently viewing.
- Ensure that changes were made to the correct Practice or all applicable Practices. Example: Detox billing profiles were edited under ABC Treatment Center, but the same changes were not made under 123 Treatment Center.
- Ensure that the claim is associated with the edited UR plan or attendance record. Example: Edits were made for the UR plan from 4/10/18 to 4/15/18 but the claim is associated with the 4/16 to 4/20/18 UR plan.
- Ensure that Effective Dates and Scheduled Change Sets encompass the dates of service on the claim. Example: If a claim rule has a scheduled change set to become active on 2/15/23 and the claim has a date of service of 2/10/23. The claim rule will not impact the claim. Backdate the rule so it is active on or before the date of service on the claim.
- Pay attention to similarly named Services and Billing Profiles. Example: Changes were made to the service, Family Therapy w/out Patient but the service on the claim is Family Therapy w/ Patient. Corrections would not prompt for the service, because no changes were made to the service.
- Ensure that the service is referenced in the Facility in Practice Admin > Facilities.
- If the service needs to go out as professional make sure there is a Professional Service Line and a Professional Unit Rate.
- Check the Claim Rules. If there are conflicting changes, claim rules will override other settings. Example: The service billing profile in the patient’s UR tab dictates that the claim should go out as professional. There is a claim rule to set the claim type to Institutional. The claim rule will take precedent and the claim will go out as institutional.
- If using claim rules, ensure that all conditions are met by the claim that needs corrections.
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