Case Consolidated Claims Program

This section provides information on how to enable the consolidation all encounters related to a clinical episode of care. Only encounters with an Encounter Rate SIM are considered Case Consolidated Services (CSC) candidate encounters.

To set up the application to add all encounters related to a single episode of care to a single claim, perform the following procedures:

• Set up the Encounter Rate Billing library to identify types of encounters eligible for consolidation.
• Set up the Consolidated Case Claims Rules in the Consolidated Services Claim library.
• Setup Rules for Consolidation of Case Claims