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Open Closed Charges - Cal-PM

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Reopen charges to a client or batch that have been closed.

Avatar PM > System Maintenance > Client Maintenance

  • If you are opening closed charges and using the default of 'All,' you will still need to select subsequent pages if there are multiple pages of services and then click "ok" to each page. Otherwise only that first page will be selected for re-open.
  • When a service originates from MSO with Other Health Care information, third party payments, and adjustments identified, it will be PREVENTED from being opened. The claim was adjudicated in MSO based on how the claim received, which may have included having adjudication form other payers. Allowing the service to be opened in PM compromises the linking between MSO and PM. In addition, there would be risk that MSO services could be incorrectly updated once remittance is received.

Steps

  1. In the Individual Client Or Interim Batch field, select either Individual Client, Interim Batch, or Quick Billing Batch.
    • When Individual Client is selected, myAvatar will require a client in the Client ID field and an episode in the Episode field. Pre-admission episodes are included in the Episode list.
    • When Interim Batch or Quick Billing Batch is selected, select the appropriate batch from the corresponding drop-down menu. The Quick Billing Batch field contains clients that have received a claim or had services closed as result of the Quick Billing process.
    • Once a selection has been made, the other choices will be greyed out to ensure only the appropriate fields are filled in.
  2. Specify a start and end date.
  3. To include services that have already been claimed, select Yes in the Include Claimed Services field.
    The following charges cannot be opened:
    • Reclaimed charges
    • Transfers
    • Components of a roll-up service
  4. The 'Default All Or None' field controls how claims are selected.
    • Choose All to select all claims in the Open Closed Charges screen.
    • Choose None to have no claims selected in the Open Closed Charges screen.
  5. Click 'Select Charges to Open' to display the Open Closed Charges screen.
  6. Select the claims to be deleted, then click Ok.
  7. Click Submit.