How do we bill for “Other Time” if the progress note is generated at a later time?
Our progress note records the Total Hours and Minutes and the clinician breaks the time down by “face-to-face” and other time (which is usually the time used to generate the progress note). DMH requires that face-to-face and other time must be submitted for billing as one progress note (one EDI claim). Most software application including Sigmund uses a scheduler to generate a claim; the software will record the “Start and End” time. A clinician may not complete the note within the actual time bill, they may write the note later in the day (issues include access to a computer when out in the field, scheduling issues and etc.) When an 837 EDI claim comes in, it should contain the total time already. The claim does not break out face-to-face and other time. Medi-Cal allows up to 12 months to bill (late codes used for claims passed 6 months but not over 12 months). This implies waiting until all data are ready before submitting the 837. How does the current IS system calculate the rate for
