QHR Product Ideas

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Billing Rules for "within x days of" should check back and forward

If a date-limiting rule is created, it should be able to check the restriction in the past, as well as forward in time from the date being billed. Because not all billing is always done chronologically, it's possible that a bill can be created that conflicts with the rule in the case where the billing is for a visit taking place before another already-billed visit that has happened on a later date. The wording when creating a rule says: "CODE billed X times within Y days of CODE", but the rule itself is, "CODE has been billed X times within the last Y days." These are slightly different concepts. Billing rules should reflect the former wording instead of just "the last x days".
  • Guest
  • Jun 20 2016
  • Needs Review
Accuro EMR / Billing
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    • Guest commented
      19 Mar 22:21

      I need to be able to set a rule that changes A234 to A244 if A234 has been billed within 180 days IN THE PAST. currently, it only allows me to set the rule if it was billed twice "within 180 days". The problem is, if I am billing after the patient has left and made a follow up appointment, then A243 may have automatically been applied (by default) to their future appointment, causing the rule to change my bill for the current appointment. What SHOULD happen, is that my Bill for A243 goes through for the current appointment (because changing the rule to "not been billed within the PAST 180 days would mean there is no conflict with the future appointment), and then at the next appointment the A243 automatically gets switched to A244 when the rule is activated. The current method makes the billing rules feature essentially unusable for this if I am going to also have a default procedure code automatticaly attached to appointments when they are booked

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