Submission Batches

Q:  Validation Message:  Visit not qualified because not all the scheduled visits are created for the day.

A:  This validation error message alerts the biller that the client had more than one shift for the date of shift and both visits are not on the same claim.  Billing rules for payors required all shifts for a single date of service for the same level of service to be billed together.  (All PCA shifts for the day are on the same claim).

The most common reason for the error is when the second or third shift for the day is processed after the billing of the other shift(s) for the day.  Example of when this happens is when one of the shifts was completed by a timesheet instead of EVV.  

CORRECTION PROCESS:

1.       Go to the billed visit for the date – Billing Tab – Click Edit - and copy the payer claim control #.  Check the box “Mark for Resubmission”  Save Billing Info.

2. Go to the additional visit(s) for the date – Billing Tab – Click Edit - paste the Payer Claim Control # from the billed visit in step 1.  Mark for Resubmission.  Save Billing Info

3. Go to Billing Module – Creating – Ready for Submission Tab - and select the client and date of service, use the drop down to select “ready for resubmission” and select Rebilling – YES.  PROCESS claim as per normal billing processes.