This function in Clinical Management for Behavioral Health Services (CMBHS) is a system-generated record for each day a client has an open Residential Service. CMBHS will generate a Day Rate Attendance Record for each day a client is receiving services based on the Service Begin and Service End documentation. Providers will select the days the client received Residential services and submit the Day Rate Attendance Record for payment. These claims are referred to as Institutional Claims.
The CMBHS user must be assigned a role in CMBHS which allows Read-Write access to the Day Rate Attendance Record page to document on this page. Click here to view a list of Page Rights by Roles in CMBHS.
Your organization determines your billing schedule and who will use the Day Rate Attendance to select the clients and service dates for billing purposes.
HHSC requires that providers use the Day Rate Attendance Record for the following Substance Use Disorder services: Residential Detoxification, Ambulatory Detoxification, Intensive Residential, and Supportive Residential services.
Review your HHSC Contract to verify the services that must be documented in a Day Rate Attendance Record.
CMBHS will generate a Day Rate Attendance Record for each day a client is receiving services based on the service type indicated in the Service Begin and stops generating them based on the completion of a Service End.
If a Discharge or a Service End is documented, the system will stop generating Day Rate Attendance Records. Make sure all service dates have been billed.
If Day Rate Attendance Records have been billed, and a Discharge or End Service is documented for a date before the Day Rate Attendance Record, the system will recoup for any claims paid after the Discharge or Service End date.
CMBHS will create a Day Rate Attendance Record for the client after you create a Begin Service for a service that requires use of a Day Rate Attendance Record. The Day Rate Attendance Record will be displayed on the Day Rate Attendance Record List screen that you access from the Provider Tools menu on the Administrative Toolbar.
This page allows you to search for submitted or non-submitted Day Rate Attendance Records using a date range, location, client number, or service type. The client number and the service type fields are optional.
Begin by selecting the Search Day Rate fields to locate the Day Rate that will be submitted for billing.
Search Fields are as follows:
Business Location – This will default to the current location where the user is logged in. To change the business location, select the arrow to the right of the field or click anywhere in the field and the dropdown list will be displayed.
Funding Source – This list is populated with:
Services Provided Between
The difference between the Begin and the End date cannot be more than 92 days.
Show All (This will display both Saved and Unsaved records for the date range) – Checkbox field. CLICK to enter a check mark for Show All saved and
unsaved records.
You can use the second search box, Additional Search Criteria, to indicate the location, CMBHS Client Number, or service types for which you are searching.
Search Fields are as follows:
The column headings are as follows:
The billing person will determine which Day Rate Attendance Records will be submitted for payment and will select the YES radio button to indicate the client received services on that day for the displayed Service Type. Once the page is completed, the billing person will select the Save button. If the billing person would like to select all the lines displayed, she or he can use the Select All Yes button. The system will mark all the YES radio buttons. If the billing person does not want to select any lines, they can use the Select All No button. The system will mark all the NO radio buttons.
The system will display a report showing the day rates that were submitted. This report can be printed or exported to Excel. Click here for more information on Reports.
After you submit a Day Rate Attendance record, it can be viewed on the Pending Claims page under Business Office on the Administrative Toolbar at the top of your screen.
When the Pending Claims menu item is selected the Search Pending Claims page will display.
Current Pending Claims can be located by using any combination of the data fields available on the Search Pending Claims page. After filling in the search criteria, CLICK the Search button. Any pending claims during the time period will display.
Review each pending claim for accuracy. Also, if the bottom left of the screen shows multiple pages, review each page before CLICKING the Submit Claims button.
Select the appropriate Contract from the dropdown list in the Contract field and the system will checkmark the Submit Claims box, indicating that the claim(s) will be submitted for payment.
Remember, if the Financial Eligibility Number (FE#) column is blank, the client does not have a valid Financial Eligibility and the claim will not submit for payment.
You will get a confirmation message when the claim has been Successfully Submitted.
A list of the claims that were submitted will be displayed. This list can be printed or exported to Excel.
The Day Rate Attendance Record can be viewed from the client's Client Workspace. Scroll down toward the bottom of the page to the Document List. Locate the Day Rate Attendance Record for the date you need. Highlight the record and CLICK ON the View button. The document will open for viewing.