Update the Service End Date

Billers might choose to show the service end date as the discharge date, the final service date on a claim, or that date plus one day. This rule guides the system on how to present the last service date on a claim. 

Workflow

Let's review how to create a claim rule to manage how the system displays the last date of service on a claim!

1. Navigate to Management Center > Claim Rules.
   
2. Click Create Claim Form Rule.
3. Select the practice.
   
4. Next, give the rule a name.
5. Update the Claim Type drop-down to Institutional or Professional and change the order of the rule when applicable.
6. Then select the desired conditions to create the criteria a claim should meet before the rule will apply.
   
7. Next, click on the drop-down below Behaviors, select Service End Date, then click Add.
8. Update the dropdown to one of the following:
   
   1. Use Discharge Date to use the discharge date from the treatment episode. 
   2. Use Last Date of Service to use the last date of service recorded. 
   3. Use Last Date of Service +1 day to use the date that occurs 1 day after the last date of service.
9. To create multiple behaviors, repeat steps 7 and 8.
10. Click Save to complete the process.
    

Box Number(s)

• UB-04: Box 6 - Statement Covers Period
• CMS-1500: Box 24a - Date(s) of Service

Frequently Asked Questions and Helpful Hints

Let's review some helpful hints and some more commonly asked questions!

Frequently Asked Questions

• The best way to determine if a scheduled change set is appropriate is to gauge how many claims will be affected. For example, if you want the rule to apply to previously billed claims as well as new claims going forward, create the rule without a scheduled change set. 
  
  However, if you want the rule to apply only to newly created claims, use a scheduled change set to instruct the system to look only for claims with dates of service on or after the set date. For more information on scheduled change sets, click here.
• If you are creating the rule to apply to previously billed claims, navigate to the Patient > Treatment Episode > Claims > Review Corrections section and click Check For Corrections. If corrections are generated, follow the process outlined here to complete the process. If no claims are flagged for rejection, click here to troubleshoot why the rule may not be applying.

Helpful Hints

If one of your conditions is payer-based, select any applicable Current Sequence options instead of the Primary Behavioral Payer. This will ensure the rule applies to secondary and tertiary claims when needed. To read more about how to set claim rule conditions and order, see the Claim Rule: Setting Claim Rule Conditions article.