Problem Statement

Claims must price correctly the first time, or they pay wrong and generate rework. Home Health providers are reimbursed at Medicare rates, and that pricing requires an admit date on the claim, but because a Home Health claim carries an outpatient bill type (32x), core Facets doesn't populate the admit date on the claims screen. Left blank, the claim prices incorrectly and has to be reworked after it denies or pays incorrectly.

Automation Solution

This automation populates the Facets admit date from the start date on Home Health claims with bill type 32x where the admit date is blank, so the claim prices correctly at Medicare rates and avoids downstream rework.