This feature will create a list of episodes that have a chargeable visit but an episode has not been created - even if the 485 has not been created yet. An episode is considered missing if a chargeable visit is found for a PPS payer and there is no episode in PPS Tracking that starts on the correct 60-day interval from that patient's start of care date. Also, if there are chargeable visits for more than one PPS payer, then a duplicate payers alert is printed. The report goes back 12 months to search for episodes.
You can find this feature from Barnestorm Office click on Reports > Billing > 14.03 PPS Tracking Report. Click on the Search for Missing Episodes tab.
o Create Missing Episodes = Check this box if you want to automatically create the episodes. Leave it unchecked if you want to review the list that is generated before creating the episodes.
o Export to Excel After Printing = Check this box if you want the report to generate into an Excel after you close the Barnestorm report.
o Program(s) = Put in a specific program #(s) or leave blank for all.
o Check For Multiple PPS Payers = Check this box if you want the report to generate a listing of patients with multiple PPS Payers.
o Click on Search for Missing Episodes when you're ready to run the report.
The report will show you details about the episode that was or will be created. It will also show you problems found for that episode; visit date issues or multiple payer issues.
EOE With Wrong D/C Date Report:
At the bottom of the screen is an option to print episodes where Thru Date on the billed EOE no longer matches the discharged date in the system. Click that option to run the report.
Troubleshooting Tips:
o If eval only episodes are showing up; check to see if the payer is PPS and if the visit entered is chargeable. The visit must be a non-chargeable, otherwise it will get picked up on the report.
o If any episode shows up on the report, where the episode has already been "paid/discharged," pull up the chart/episode and review the following:
a. Go to Billing > PPS Billing > Edit PPS Episode, make sure the discharge date matches the "thru" date of the claim. Check to see if changes were made, after the claim was created, ie. an additional visit was keyed in.
o Other areas to review: (1) Make sure visits have correct payer; (2) Make sure 1st charge visit matches up with SOC date.
o If corrections are made and the episode needs deleted; use the Billing > PPS Billing > Edit PPS Episodes to delete the episode.