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CCBHC PPS Service Definition - PM

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Determine how the PPS trigger charge for both PPS-1 and PPS-2 rates should be created based upon individual component services.
  • The system will not allow both a PPS-1 and a PPS-2 definition to be active at the same time.
  • If applicable, there can be more than one active guarantor-specific definition. There can only be one active generic (not qualified by guarantor) PPS definition.

Prerequisites:

  • Services codes relevant to CCBHC must be defined in the Service Codes form with a value of Yes in the Is this a CCBHC Service field. Only those codes will be available in this form.
  • CCBHC Programs must be defined in the Program Maintenance, or Single Program Maintenance form with a value of either Service or Both in the Usage Type field (added via the Enable "Admission vs. Service Program" Functionality registry setting). Only those programs will be available in this form.
  1. Go to: myAvatar PM > System Maintenance > System Definition > Service Code Maintenance > CCBHC PPS Service Definition.
  2. In the Add or Edit PPS-1 Service Definition field, select whether to Add or Edit a service definition.
    • If Edit, select the previously saved PPS-1 file to edit in the Existing PPS-1 Service Definition field.
  3. In the Effective Date field, enter the starting date for this service.
  4. If applicable, enter the final date for this service in the End Date field.
    An End Date must be entered in order to add another definition with a later Effective Date.
  5. If desired, in the Guarantor field, select the specific guarantor to associate with the service.
  6. In the PPS-1 Service Code field, search for and select the service code.
  7. In the Assigned Service Program field, search for and select the service program to which the PPS charge will be assigned.
    If this field is left blank, the PPS charge will be assigned to the service program associated with the first enumerated visit found for the client.

Service From Date for Scheduled Compile

  1. In the Add CCBHC PPS-1 Compile to Scheduler field, select whether or not to add the "PPS-1 Compile" option to the System Task Scheduler so that the PPS-1 compile process can be schedule on an on-going basis. If Yes:
    • In the Number of Days Prior to Current Date field, define how many days prior to the current date to look for CCBHC services.
      When the compile is run from the System Task Scheduler, the process will select all services that have a date of service which is within the number of days entered from the current date.
    • In the Service Through Date for Scheduled Compile field:
      • Select Current Date to have the compile process select all CCBHC services through the current date when run on the System Task Scheduler.
      • Select Last Day of Previous Month to have the compile process select all CCBHC services through the last day of the prior month when run on the System Task Scheduler.
  2. Click File PPS-1 Service Definition to file the definition. The system checks to make sure that there are no overlapping dates for PPS-1 and PPS-2 definitions.
► Additional Section
► See Also
► SQL Table
  • SYSTEM.ccbhc_service_definition