Charge Management Actions

Charge Management Actions

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

  1. Select the Charge Management button from Libraries on the Left Side Menu.

  1. Select the Add button.

  1. Add a Description.
  2. 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.
  1. Batch Validation: Uncheck.
  2. Validate When Conditions Are: Select Met.
  3. Tag Assignment: If you want a Tag to be created to review later, select the Tag Assignment using the Lookup icon.
  4. 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.
  1. Enter a Validation Message.

  1.  Enter your Criteria.

  1.  In the Actions panel:
  • Select the Insurance you want to change.
  • Claim Insurance Billing Groups: Select if applicable.
  • Select the applicable option from the Field dropdown.
  • Action: Select the Action.
  • The Action options vary based on the Field selection.
  • 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.


Learn More

Charge Management Actions Examples

Charge Management Tag and Worklist Assignment

Charge Management Rules

Charge Management Rule Examples

Charge Management Rules Show & Tell


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