Re-enable Ability to Edit Billable Units & Billable Amount

In a release earlier this year, Netsmart removed the edit functionality from the Billable Units and Amount fields on the Claim Work List screen as part of an enhancement to calculate these values automatically rather than entered by billing provider when visits are claimed on an 837 by Netsmart. Experience since this change has revealed that even with automatic calculation of this value, there are claim service lines that still need adjustment. The predominant drivers are incorrect rates sent by the 3rd party vendors, billing providers not maintaining their rate overrides in a timely manner, and valid needs such as some services that do not abide by the standard rate calculation. As such, Netsmart will be re-enabling the ability to edit Billable Units and Billable Amount in Production version 22.10 scheduled for release on May 18, 2022.

Enhancements included are:

1. On the Claim Worklist, the pencil icon has been added back to the Billable Units & Billable Amount fields so that these values can be edited for visits for all payers except Nebraska Department of Health and Human Services (NE DHHS).

2. On the Claims Worklist, only the Calculated Units and Calculated Amount fields will be updated when the
   'Recalculate' icon is selected. If Billable Units and Billable Amount are provided on the Rendered Services feed, these values will not be overwritten during claims matching or if the user selects to Recalculate Amount for all payers except NE DHHS. For visits for NE DHSS, the system will overwrite the Billable Units and Billable Amount as it currently does today.

3. On the Claims Worklist, if Billable Units and Billable Amount are entered manually in the Claims Worklist, these values will not be overwritten during claims matching or if the user selects to Recalculate Amount for all payers except NE DHHS. For visits for NE DHSS, the system will overwrite the Billable Units and Billable Amount as it currently does today.

4. On the Claim Adjust screen, the pencil icon has been added back to the Billable Units & Billable Amount fields so that these values can be edited for visits for all payers except NE DHHS.

5. On the Claim Adjust screen, the pencil icon will be displayed for the Prior Authorization, Procedure Code, Billable Service Start, and Billable Service End fields for all payers except NE DHHS. For NE DHHS, provider admins will continue to update the Billable Start Time and Billable End Time fields via the Adjust Billable Time screen accessible via the snowman menu as currently working in Production. Any changes made will update the Billable Units and Billable Amount fields as it currently does today.

NOTE: These changes do not impact providers submitting 837 claims for EVV from their EHR.