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Billing Options Field Descriptions

Use the following table to setup billing options.

Field	Description
Select Place of Service on roll-up:
Select Override Place of Service	This setting determines which Place of Service (POS) code is used on claims when multiple Behavioral Health (BH) charges on an encounter with different POS codes roll-up to a single line item on the claim. Select one of the following options: Send POS from first line item: This option is selected by default. Select this option to populate claims with the POS code from the first BH charge on the encounter. Send POS from charge with highest Chg Amt: Select this option to populate claims with the POS code from the BH charge on the encounter that has the highest charge amount. Send POS from encounter Service Location: Select this option to ignore the BH charge-level POS codes, and instead populate claims with the POS code linked to the encounter-level service location. Select Default POS: Select this option to select a specific Default Place of Service to be used on claims. This field is required. Do not roll up when POS different: Select this option to prevent multiple BH charges on an encounter with different POS codes from rolling-up to a single line item on claims. Each BH charge on the encounter is listed separately on the claim with its corresponding POS code.
Select Diagnosis Codes on roll-up:
Select Override Diagnosis Codes	This setting determines which ICD codes are used on claims when multiple Behavioral Health (BH) charges on an encounter with different diagnoses codes roll-up to a single line item on the claim. Select one of the following options: Send diagnosis codes from first Behavioral Health line item: Select this option to populate claims with the diagnosis codes from the first BH charge on the encounter. Send diagnosis codes from Behavioral Health line item with the highest charge amount: Select this option to populate claims with the diagnosis codes from the BH charge on the encounter that has the highest charge amount. Do not roll up when diagnosis codes are different or not in the same order: Select this option to prevent multiple BH charges on an encounter with different diagnosis codes, or with the same diagnosis codes but in a different order, from rolling-up to a single line item on claims. Each BH charge on the encounter is listed separately on the claim with its corresponding diagnosis codes. Note: For Behavioral Health Billing libraries created prior to version 5.9 UD1, this option is selected by default to preserve legacy functionality.
Auto-balance variance amount on COB claims:
Adjustment Reason Code for CAS Segment	When a variance charge is added during the billing process for a non-primary payer, the prior payer's billed amount does not match, and the secondary/tertiary electronic claim is thrown out of balance. This causes the secondary/tertiary claim to be rejected by the clearinghouse or payer. To auto-balance the variance amount on COB claims, select a code from the HIPAA X12 Standard Reason Codes library. The selected reason code and the variance amount will populate the CAS segment on COB claims, and the Payment Entry > COB window. This keeps the COB claim in balance and prevents the need for manual manipulation.

Billing Options Field Descriptions