MCG+ Critical Update 22.12.2
Netsmart will be releasing a critical update (22.12.2) to Production at 7pm EDT this evening, Friday, June 17th to address issues that providers are encountering while editing the Billable Start/End Time, Procedure Codes/Modifiers, and Prior Authorizations on the Edit – Billable Time, Procedure Code/Modifiers, and/or Prior Auth screen.
Below is a detailed description of each issue identified on this screen that will be addressed in critical update:
NTSTEVV-7045 – Providers were receiving unmatched claims due to RNOT (Rate Not Found) error. Investigation determined the modifiers selected for the procedure code were not saving when providers corrected visits with incorrect procedure codes/modifiers
NTSTEVV-7073 – When editing the prior authorization, the Prior Authorization drop-down did not display any authorizations. Investigation of this error determined that when the Billable Start/End Time fields were left blank, the drop-down list was not populated.
NTSTEVV-7080 – When the Billable Start/End Time, Procedure Codes/Modifiers, or Prior Authorization screen is left blank, the system was incorrectly saving ‘Null’ edits in the Edit’s and Errors section.
There has also been confusion on how providers should utilize the Edit – Billable Time, Procedure Code/Modifiers, and/or Prior Auth screen, so the information below outlines how this screen should function.
Providers will NOT be required to edit or enter any of these fields, however, as soon as they do make an update to one of the fields, they will be required to enter a Reason Code associated with that field. For example, when a user clicks on the pencil icon to edit, it will default to the Billable Service Date/Time section. If the billable service start/end has not changed do NOT update the field.
Billable Service Start Date/Time & Billable Service End Date/Time
The screen will default to saved values if they were previously entered, otherwise the field will default to blank. If no changes are made, no reason code is required and the billable start/end times will not be recorded as changed when the screen is saved. If changes are made, the reason code is required. If Other is selected, the user will be required to enter Notes, as well.
Procedure Code/Modifier Updates:
The screen will default to the previously saved Procedure Code/Modifier. In order to edit the Procedure Code/Modifier value, users must delete the previously saved value and then all procedure codes/modifiers configured for the payer will be displayed in a drop-down list. If no changes are made, no reason code is required and the procedure code will not be recorded as changed when the screen is saved. If changes are made, the reason code is required. If Other is selected, the user will be required to enter Notes, as well.
Prior Authorization Updates:
The screen will default to the saved value in the Manual Override PA # field if previously entered, otherwise the field will be blank. If the field is populated and the checkbox is selected to activate the authorization drop-down list, the system will remove the previously populated value and will display a list of authorizations based upon the selected procedure code AND the Billable Start/End dates, if present. If not present, the system will use Actual Start/End Dates AND the procedure code to find the applicable authorizations.
If no changes are made to the authorization, no reason code is required and the prior authorization will not be recorded as changed when the screen is saved. If changes are made, the reason code is required. If Other is selected, the user will be required to enter Notes, as well.
Rematching Claims
If the user makes any changes on this screen, they will need to run the claims matching process again by selecting the record and selecting the Rematch button.
Correcting RNOT Errors
If you edited any Procedure Codes and received the RNOT error, you will need to update the procedure code/modifier again, so that this time it’s saved with the modifiers, and then rematch the claim.