Prebilling Problems and Resolutions

Unbalanced Visit

1. Click on the Edit Icon to open the visit window.

2. Navigate to the Schedule tab.

3. Adjust the Schedule Time to satisfy your Agency’s/Office’s Unbalanced Tolerance time.

4. Click Save.

Incomplete Confirmation

1. Click on the Edit Icon to open the Visit window.

2. Navigate to the Visit Info tab.

3. Click the Link Call button to search for a usable EVV confirmation.

4. If no EVV confirmation is present, manually enter the Visit Start Time or Visit End Time, depending on which one is missing a confirmation.

5. Click Save.

With TEMP Caregiver

1. Click on the Edit Icon to open the visit window.

2. Navigate to the Schedule tab.

3. Enter the Caregiver Code in the Caregiver Code field. Use the “?” link to search for a Caregiver if the Code is not known.

4. Click Save.

Caregiver Compliance

1. Click on the Caregiver Name (link) to access the profile.

2. Select the Compliance page from the Index.

3. Check the Compliance Status for the Contract that authorized the visit.

4. Click Compliance Check to view compliance rules and determine the issue.

5. Correct validation issue(s).

POC Compliance

1. Review the Contract’s Required Compliance rules.

2. Click on the Edit Icon to open the visit window.

3. Navigate to the Visit Info tab.

4. Manually enter the Duties to satisfy the Required Compliance rule.

5. Click Save.

Overlapping Shifts

Shift Overlapping / Caregiver Overlapping

1. Click on the Edit Icon to open the visit window.

2. Navigate to the Visit Info tab.

3. Update either the Visit Start Time or Visit End Time.

4. Click Save.

OT/TT* Not Approved

* Overtime/Travel Time

The OT/TT Not Approved validation only checks visits authorized by Linked Payers. If a visit is held because of this validation it means that a user has requested Travel Time or Overtime from a Linked-Contract and the Contract has neither responded to nor rejected the request.

This visit remains in Prebilling as OT/TT Not Approved until the Linked Contract has responded/approved the request.

Restricted Caregiver

1. Click on the Caregiver Name (link) to access the profile.

2. Select the Absence/Restriction page from the index.

3. In the Restrictions section, edit either the Restriction Start Date or Restriction End Date for the visit to fall outside the restricted date range.

Timesheet Not Approved

1. Click on the Edit Icon to open the visit window.

2. Select the Visit Info tab.

3. In the Audit section, select Timesheet Approved checkbox.

4. On the Upload Scanned Timesheet field, click the Paperclip Icon () to upload the Timesheet.

5. Click Save.

Insufficient Duty Minutes

1. Click on the Edit Icon to open the visit window.

2. Select the Visit Info tab.

3. In the Audit section review the Duty Sheet POC value. The number in the parentheses is the total time for performed Duties.

4. Edit the Visit Start Time or Visit End Time to match the Duty minutes to the visit duration.

Clinical Documentation (Skilled Visits only)

1. Click on the Edit Icon to open the visit window.

2. Select the Visit Info tab.

3. In the Clinical Documentation section, enter the Clinical e-Doc. Click on the Add link to manually enter, or click on the paperclip icon to upload the document.

Authorization

1. Click on the Patient Name (link) to access the profile.

2. Select the Calendar page from the Index.

3. In the Last 3 Authorizations section, review the authorization rules of the Contract associated with the visit.

4. In the Calendar section, click on the visit times to open the visit window.

5. Adjust the visit information to satisfy the authorization rules.

Custom Validations

Custom Validations is a catch-all Prebilling status for any custom Prebilling rules that have been configured for an Agency.