Claim Submission: Zero Amounts

There are some new requirements with regards to the submission of ZERO amounts.
E.g. Discovery has new codes that need to be captured with zero amounts and have to be submitted.

After investigation, the following was found:

1. ZERO amounts for Nappis will always be submitted.

2. Procedure items with Zero amounts will NOT be submitted if the tariff_type is one of the following:

  • ZERO,
  • EXTRA_DIAGNOSIS, LOCUM

3. A possible problem occurs during billing:
The system automatically changes the tariff_type to "Z" (zero) if the billing amount is zero AND the following criteria is met:
  • code is NOT classified as a modifier,
  • code is NOT ICU time.

Conclusion:
The system will allow submission of zero amounts if the tariff code is configured as a modifier. Nappi (Stock) items will be submitted regardless.

Last modified: Thursday, 18 July 2019, 2:26 PM