Update the Service End Date

Billers may want to display the service end date as the discharge date, the last date of service on a claim, or the last date of service plus one day. This rule instructs the system how to display the last date of service 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 Claim Form Rule.
     
  3. Select the Practice.
     
  4. Next, give the rule a name.
  5. Update the Claim Type to Institutional or Professional.
     
  6. Select Conditions to create criteria a claim should meet before the rule will apply.
     
  7. Next, click on the Behaviors dropdown.
  8. Select Service End Date.
     
  9. Next, click Add.
     
  10. 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.
         
  11. To create multiple behaviors, repeat steps 7-10.
  12. Click Save to complete the process.
       

Box Number(s)

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

Helpful Hints

• If one of your conditions is payer-based, select Current Sequence Behavioral 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.
• To read more about how to set up a claim rule to be effective as of a certain date, see the Scheduled Change Sets article.