Charge Management Rules and Actions
Charge Management Rule Examples
Alert for Provider Credentialing There is a System delivered Charge Management Rule to display a Validation Warning for Providers who are not yet Credentialed with a Specific Insurance. Use this link for more detailed documentation: Hold Billing for ...
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 ...
Charge Management Rules
Using the Charge Management Rules, create Validation Rules to catch common errors before Claims are sent to the Payer. These Rules are customizable to suit the specific needs of your practice. Using these rules can reduce the amount of rejected ...
Charge Management Action Examples
Add a Legacy ID in HCFA Box 33b for a Secondary Payer Scenario: BCBSTX is Primary and MagnaCare is Secondary. MagnaCare wants a Legacy ID in Box 33b on the HCFA (Paper Claim), but the Primary, BCBSTX, does not require this. Criteria Select ...
Charge Management Tag and Worklist Assignment
Assign a Tag to a Charge Management Rule Access: Libraries > Charge Management Rules When a Tag is assigned to a Charge Management Rule, and the Charge meets the Rule's criteria, the Tag will be auto-assigned to the Encounter. On the Add/Modify ...