Minimum Service Duration Warning or Error

This article describes a 2024 planned feature delivered through the myAvatar Product Roadmap. This information is subject to change.

What are we doing?

Adding the ability to define minimum service durations required by Service Code and creating settings to display either a warning or error to an end user when documenting a Note or entering a charge when the minimum service duration is not met.

Why are we doing it?

With new rules being implemented by various payers, agencies are billing for new Service Codes with more stringent billing rules than they’ve previously had to abide by. An example of this is that there are now minimum duration thresholds to allow a service to be billed. In the solution, a particular Service Code may be configured as 15 minutes per unit with rounding at the half unit. This means that one unit of the service can only be billed if the service duration is 8 minutes or longer. If the service provided is for a duration of 7 minutes or less, an agency is not allowed to bill for that unit. Agencies are reporting that they have many services being delivered that do not meet the minimum duration threshold. Rather than expect a clinician or end user to know and understand what these minimum duration requirements are, clients are requesting a product update to display a warning or error to inform an end user of the requirements.

How are we doing it?

Allowing Service Codes to be configured with a set minimum duration allowed for billing purposes. Adding settings to either warn or error during note or charge entry when a service does not meet it's minimum service duration:

- A soft warning to end users when they are documenting a progress note or entering a charge that does not meet the minimum duration for the service to be billed. In this instance, the agency may want to better inform end users of what the minimum duration requirements are but still allow for the filing of the note.

Or

- A hard error to prevent end users from filing a progress note or entering a charge that does not meet the minimum duration for the service to be billed. In this instance, the agency may want to train end users to abandon writing a note or entering a charge for a service they know is non-billable. They may need to write an Informational Note instead of a Progress Note to document contact with the client.