Knowledge Base Article #1179:

Alternative method to exclude a patient from Medicare billing

There are cases that we cannot find the patient or the episode that needs to be excluded from Medicare billing ...under the "Workflow/Exclude Pts From PPS Billing" Module.

What other alternative method can we do in order to exclude a patient from Medicare billing?

The episode will not be displayed in the WORKFLOW 'exclude grid' if the final claim has been processed for the episode (either as PENDED or CLEAN)

You can continue to hold the final claim by creating a supplemental order (shell only, no content), enter a mailed date and enter comment into notes field to indicate "that this supplemental order was created for admin purposes to hold a final claim" -- the PPS FINAL CLAIM cycle will place this FINAL as PENDED due to MD signature needed for a supplemental order -- once you are ready to send the final claim, enter a physician signed date for the supplemental order

Keywords: careportal, Medicare, billing, PPS, report, corrective action, FINAL CLAIM
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