Charge Management Actions
A Charge Management Action can add or replace information or leave a field blank on a Claim or Encounter.
These were previously controlled by Cross Codes, Provider IDs, and Insurance IDs.
Scenario: A Payer requires different information on a Claim that other Payers do not require.
Many changes can be accomplished using the Actions panel on the Add/Modify Charge Management Rule screen.
The Charge Management Action occurs when one of the following is performed:
An Incomplete Encounter is completed
- When a Charge Type is Production and is saved on the Add/Modify Charge screen.
- When the Charge is received from the Chart Documentation and is being auto-completed.
- The Charge Management Rule(s) for an Encounter will show in the Validations panel on the Encounter Dashboard.
Add a Charge Management Action
- Select the Charge Management button from Libraries on the Left Side Menu.
- Select the Add button.
- Add a Description.
- Charge Entry Validation:
- None: No Charge entry validation.
- This would generally be used in conjunction with a Batch Validation in situations where Charges are not manually entered.
- Warning: Displays the Validation Pop-up each time an Update is being performed.
- If Warning is selected, it will appear in a banner on the Modify Charge screens, which can be useful when viewing the Charges in the future.
- Batch Validation: Uncheck.
- Validate When Conditions Are: Select Met.
- Tag Assignment: If you want a Tag to be created to review later, select the Tag Assignment using the Lookup icon.
- Apply Tags to Existing Encounters:
- Select this option to have the System apply Tags to existing Encounters. This happens one time and will apply to Encounters that exist at the time the rule is saved.
- If the goal is to create a Rule that should only affect Encounters before/after a specific date, in the Criteria Panel set the Post Date or DOS to be Greater or Less Than the specific date, or use two criteria (Greater Than & Less Than) to apply a Rule to a date range.
- Enter a Validation Message.
- Enter your Criteria.
- In the Actions panel:
Claim Insurances: Select the Insurance(s) you want to change. (Multi-Select field)
Claim Insurance Billing Groups: Select if there is an Insurance Group where you want this Action. (Multi-Select field)
Field: Select the applicable option from the System-delivered Field dropdown.
Action: Select the Action.
The Action options vary based on the Field selection. Options:
Value: The Value field displays dependent upon the Field selection.
Results of a Charge Management Action
If a Charge Management Action is triggered when the Post Charge screen is saved, a Validation Warning or Validation Error will display.
- The Validation Warning and Validation Errors will display all Actions that have been triggered with the Rule ID number(s).
- The Rule ID is a link to the actual Charge Management Action.
- A Validation Warning will display the Save and Continue button.
- The Charge screen can be saved without making any changes.
- A Validation Error is a hard stop without the ability to Save the Post Charge screen as a completed Charge.
- Tags: You can add a Tag and/or enter an Incomplete Reason and Save.
- The Encounter will remain as Incomplete until the changes are made to satisfy the Validation Error.