UR Required services like DTX, RTC, PHP, and IOP treatments require a utilization plan to be created for the patient's treatment episode before the service will appear in the Attendance Calendar. To bill for these types of services, first, create a utilization plan for the patient's treatment episode, then follow the steps below.
Creating U/R Required Services: UR required services have the toggle enabled for the setting Attendance Calendar - Requires Utilization Plan or Service Rate.
Recording Attendance for U/R Required Services
Use the following steps to record attendance for a patient:
- Ensure the correct Organization and Practice are selected.
- Open the Attendance page.
- Select the Week for the services you want to record.
- Find the patient row.
- Click the drop-down to select the U/R required service.
- You can also click the Auto-fill link to automatically add all authorized UR services to the current week, depending upon the utilization plan start and end dates.
- Clicking the (Auto-fill) link will show a dialog box detailing which services will be recorded, the date, the authorization status, as well as the authorization number (if present).
- Click Submit and the services will populate in the Attendance Calendar.
- When you're ready to submit the week's billing, click Submit Treatments.
- The services be locked and sent to the Work Center to be created into a claim.
- Navigate to the Work Center > Insurance Claims > Create Claims to create the claim for review. Click here for instructions on creating and submitting claims.
- Click Create New Claims for Selected Treatments.
- Navigate to the Submit Claims tab to review and submit the claim.
- Click here for instructions on how to make changes to the services after submission.