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Charge Options Field Descriptions

Use the following table to setup charge options.

Field	Description
Disable Variance Calculation	This check box controls whether or not a variance will be calculated for payers using this library. To enable variance calculations, leave this check box blank and complete all remaining fields on the tab. During the billing process, variance will be calculated, and a variance SIM will be added to the encounter if a positive or negative variance exists. To disable variance calculations, select this check box. All remaining fields on the tab become unavailable. During the billing process, variance will not be calculated, and a variance SIM will therefore not be added to the encounter. Note: If selected, the Claim Production Status report in NextGen® Enterprise PM displays the following green message when the encounter passes claim edits: Behavioral health variance charge not inserted due to library settings.
Insert SIM with Variance Amount on Roll-up Charges Service Item #	Select the SIM code to be added to encounters as an additional charge during the billing process when there is a “variance” in units for timed behavioral health charges that roll-up. This is a required entry. Note: The SIM code must first be created in the SIM Library with a $0.00 price.
Variance Calculation When Secondary	Select one of the following options for calculating the variance charge amount when billing the secondary payer on the encounter: Note: This setting applies when the primary payer on the encounter is not using a Behavioral Health Billing Library and therefore a variance charge was not already added to the encounter when the primary payer was billed. Sum of roll-up less prior payer transactions (default): Select this option to calculate a variance charge amount for the secondary payer that is based on the sum of the roll-up charges minus any payment/adjustment transaction amounts already posted from the primary payer. Sum of roll-up: Select this option to calculate a variance charge amount for the secondary payer that is based on the sum of the roll-up charges.
Variance Calculation When Tertiary	Select one of the following options for calculating the variance charge amount when billing the tertiary payer on the encounter: Note: This setting applies when the primary and secondary payers on the encounter are not using a Behavioral Health Billing Library and therefore a variance charge was not already added to the encounter when the primary/secondary payers were billed. Sum of roll-up less prior payer transactions (default): Select this option to calculate a variance charge amount for the tertiary payer that is based on the sum of the roll-up charges minus any payment/adjustment transaction amounts already posted from the primary and secondary payers. Sum of roll-up: Select this option to calculate a variance charge amount for the tertiary payer that is based on the sum of the roll-up charges.
Adjustment Transaction Code for Variance	Select the third-party adjustment transaction code to be used with negative variance charges. This field is required. Note: The adjustment transaction code must have the Allow sign over ride check box selected. The code will be used as a Negative to reduce the balance on the original charges and used as a Positive to reverse the amount of the negative variance charge.

Charge Options Field Descriptions