Enter Revenue and Taxonomy Codes for Linked Contracts
In the HHAeXchange system, Payers set the Service Code Rates to include the Revenue and Taxonomy Codes (per rate). Payers have the option to require Providers to enter their own unique Revenue and Taxonomy Codes via the Reference Table Management functionality under Admin > Reference Table Management > Contract Service Code. If a Provider is required to enter these codes, the Revenue Code and Taxonomy Code fields are marked with a red asterisk.
If a Payer does not enable the Provider to set the Revenue Code and/or the Taxonomy Code, the system applies the Payer-assigned codes by default although the fields may appear editable on the Service Code screen.
The Billing Review verifies existing Revenue and Taxonomy Codes for a particular visit based on settings on the Provider level. If a setting is enabled at the Provider level, the Service Code for that visit has Revenue and Taxonomy data based on those settings. If a setting is not enabled on the Provider level, then the Revenue and Taxonomy Code requirements are applied based on a Payer Service Code level.
If a visit fails any of the set rules, then it appears in the Billing Review page. The Billing Review function holds visits without a Revenue and/or Taxonomy Code so that claims are not rejected.
Once an e-billing batch is created, selected records appear in the Processing Files page and an Export can be performed. E-Billing exports must use the Provider Revenue and Taxonomy Codes associated with a given Service Code for a visit as required by the Payer.
Once an e-billing batch has been generated, a Provider can resubmit claims as an Original, an Adjustment, or a Void. In this case, the new batch export contains Provider/Payer Service Code details based on the Provider-level setup. Click the Details link to view on the Batch Details window. To search for claims, go to Billing > Electronic Billing > Batch Search (Linked). To resubmit claims, go to Billing > Electronic Billing > Resubmit Claims (Linked).
