Enforce POC Compliance at Billing Review

The POC Compliance validation can be set to hold visits at either Prebilling or Billing Review. By default, POC Compliance holds visits on the Prebilling page until an Agency representative contacts HHAeXchange to switch the validation to hold visits on the Billing Review page.

Billing Review validations can be reviewed in the Billing/Collections tab of the Contract Setup page. Click the Export/Print Validations for E-Billing and/or Paper Invoicing link. For example Item 36, Visit meets POC Compliance requirements, controls whether the system applies this validation rule for E-Billing and/or Paper Invoicing.

The POC Compliance validation behaves identically whether set for Prebilling or Billing Review. Therefore, visits must meet the Contract’s Required Compliance before they can pass either Exception page. The difference is determined by where in the billing process a visit is held due to non-compliance, as follows:

• When POC Compliance is set for Prebilling, visits that do not meet the Required Compliance cannot be invoiced.

• When POC Compliance is set for Billing Review, visits that do not meet the Required Compliance can be invoiced, but the invoice cannot be exported or printed for billing purposes.