Billable Arithmetic Enhancement

Netsmart has observed a volume of claim denials due to arithmetic errors made by billing providers when manually entering the billable claim units and amount via the Provider Portal.  Netsmart has accordingly enhanced the EVV solution reduce the number of denials due to these errors. All editable fields on the Claim Work List and Claim Adjustment screens that pertain to billable time, rate, units, and amount have been consolidated into a single dialog box so all edits can be made and saved simultaneously.  On the Claims Worklist screen.  On this screen, the billing provider will be required to enter or update the Billable Service Start and Billable Service End times, along with a Reason Code and Note. The system will then use this information to automatically calculate the billable units and amount. This enhancement is expected to reduce claim rejections due to arithmetic errors.

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Nebraska users please note that additional enhancements pertaining to the determination and use of the billable rate have also been implemented. Nebraska DHHS will provide a separate communication to you on this topic.