1 Charge Services Configuration Guide

Configuration is required for the Charge Services functionality in Oracle Health HER.

Note:

The Oracle Health Charge Services Charge agent functionality is not intended to provide treatment or diagnostic recommendations.

Note:

Configuration for existing settings is not required to configure the Oracle Health Charge Services Charge agent functionality.

To configure automatic actions for the Oracle Health Charge Services Charge agent functionality:

1. Access Oracle Health EHR as an IT administrator.
2. Select the Settings tab.
3. Select Experiences.
4. Select Charge Agent. The Oracle Health Charge Services Charge agent configuration items are displayed.
   1. To use the default Oracle-defined settings, move the Use Oracle Standard Experience toggle button to the right to turn it on, and then select Save.
   2. To set site-wide behavior for the Oracle Health Charge Services Charge agent:
      • Modifier 25 Missing
      • Modifier 26 Missing
      • Modifier 76 Missing
      • Modifier 77 Missing
      • Modifier 91 Missing
      • Modifier TC Missing
      • Charge Time Outside Encounter Range
      • Invalid Duration
      • Invalid Professional Details
      • NCCI PTP Edits (Modifier 59, XE, XP, XS, XU)
   3. As needed, select one of the following values from each of the configuration item lists:
      • true: The Oracle Health Charge Services Charge agent will automatically take steps to resolve issues for the selected configuration item.
      • false: The Oracle Health Charge Services Charge agent will not take any automatic steps. For the selected configuration item, the Oracle Health Charge Services Charge agent will display a recommended action on the Charge Worklist and will prompt users to accept or reject the recommendation. If billers accept the recommendation, the Oracle Health Charge Services Charge agent will apply the suggested change to the appropriate charges.
   4. Select Save.
5. To set custom behaviors for individual facilities:
   1. Select Manage Flexible Experiences.
   2. As needed, enter or select a configuration item.
   3. From the Flex Point list, select a flex point.
   4. From the Facility list, select a facility.
   5. From the [Configuration Item] list, select one of the following items:
      • true: The Oracle Health Charge Services Charge agent will automatically take steps to resolve issues for the selected configuration item.
      • false: The Oracle Health Charge Services Charge agent will not take any automatic steps. For the selected configuration item, the Oracle Health Charge Services Charge agent will display a recommended action on the Charge Worklist and will prompt users to accept or reject the recommendation. If billers accept the recommendation, the Oracle Health Charge Services Charge agent will apply the suggested change to the appropriate charges.
   6. Select Save.
   7. As needed, repeat steps 7b through 7f for all required flex points.

Note:

The following table provides more information about the current configuration items for the Oracle Health Charge Services Charge agent:

Configuration Item	Description	Flex Points	Data Type	Default Value
Modifier 25 Missing	Modifier 25 is missing from the charge.	Enterprise Organization, Facility	Boolean	True
Modifier 26 Missing	Modifier 26 is missing from the charge.	Enterprise Organization, Facility	Boolean	True
Modifier 76 Missing	Modifier 76 is missing from the charge.	Enterprise Organization, Facility	Boolean	True
Modifier 77 Missing	Modifier 77 is missing from the charge.	Enterprise Organization, Facility	Boolean	True
Modifier 91 Missing	Modifier 91 is missing from the charge.	Enterprise Organization, Facility	Boolean	True
Modifier TC Missing	Modifier TC is missing from the charge.	Enterprise Organization, Facility	Boolean	True
Charge Time Outside Encounter Range	The time of the charge occurs outside of the effective time range of the associated encounter.	Enterprise Organization, Facility	Boolean	True
Invalid Duration	The duration of the charge is invalid.	Enterprise Organization, Facility	Boolean	True
Invalid Professional Details	The details of the performing or supervising health professional are incomplete.	Enterprise Organization, Facility	Boolean	True
NCCI PTP Edits	Medicare National Correct Coding Initiative (Procedure to Procedure) edits have occurred, and one of following modifiers qualifies to be assigned: Modifier 59 Modifier XE Modifier XP Modifier XS Modifier XU	Enterprise Organization, Facility	Boolean	True