Billing Hold for Services Exceeding Maximum Hours Limits

The Maximum hours should not exceed the limit specified billing hold on the Billing Review page under Billing > Billing Review prevents billing for services that exceed a configured number of daily maximum hours. When enabled, this billing hold displays in the On Hold Reasons column as Maximum hours should not exceed the limit specified, as seen below.

For Linked contracts (UPR), the configured number of maximum hours (such as 12, 14, or 16 hours) is set up by authorized Payers and synced to the Provider application.

For Internal contracts, Providers configure the number of maximum hours per Service Code(s). To set up maximum hours for a Service Code, Go to Admin > Reference Table Management > Contract Service Code. Enter the Max Billing Hours that can be billed daily for the Service Code.