FCM surfaces a few Billing Support Questionnaire (BSQ) Validation Warnings in the app, both on member Billing tabs and in the Billing Support screen. These warnings help to add visibility to members who may run into billing implications. See below for the warnings surfaced (two of which are self explanatory) and one with more explanation of detail:
- Does not have Appropriateness Criteria submitted within 30 days of Consent to Enroll
- Does not have Comprehensive Plan of Care submitted within 60 days of Consent to Enroll
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Warning: most recent HCBS is over one year from potential BI service date
- This code is only supposed to flag child members who had an HCBS assessment in the past and whose most recent assessment date is over a year old.
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** There is a known validation code defect for this warning, which is flagging members who are not eligible for children's HCBS. This defect is expected to be addressed in the June 2024 MAPP HHTS update.**
- If this code, shown with the yellow exclamation point, is present on a member's record in FCM for whom this code is not appropriate, this will not prevent Users from completing a BSQ for their member and billing those dates of service. If this is applicable to a member on a User's caseload, please reach out to the appropriate Health Home contact for further guidance on billing for these members.
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** There is a known validation code defect for this warning, which is flagging members who are not eligible for children's HCBS. This defect is expected to be addressed in the June 2024 MAPP HHTS update.**
- This code is only supposed to flag child members who had an HCBS assessment in the past and whose most recent assessment date is over a year old.