A repeatable routine for closing out a billing period without leaving revenue behind.
A repeatable routine for closing a billing period without leaving revenue behind.Run it in this order. Each step depends on the one before, and skipping the early ones is how visits
end up delivered but never billed.
Apply the reason code that matches what actually happened.
3
Confirm visits reached COMPLETED
Only completed visits without outstanding exceptions can bill.
4
Check aggregator status advanced
A visit accepted locally still needs aggregator acceptance.
5
Note systematic failures
Repeated geofence failures for one member mean a wrong address, not a reason code problem.
Do not close the period with exceptions outstanding. Those visits will not bill, and the longer they
sit the closer they get to the timely filing deadline.
OfficeRidge runs two checks that find exactly what a manual close is looking for. Start from their
findings in Quality and audits rather than hunting record by record.
Check
What it finds
How it escalates
Unbilled Visit Sweep
Verified visits that never reached a claim, over a 60-day lookback
MEDIUM, then HIGH at 21 days, CRITICAL at 45
Timely Filing Deadline Watch
Claims approaching their filing deadline
MEDIUM, then HIGH inside 7 days, CRITICAL once passed
The default filing window is 95 days for Texas Medicaid unless a payer contract sets its own
limit. A CRITICAL timely-filing finding means the window has already closed and the claim is
likely unrecoverable. Work HIGH findings first.
Turn on the morning brief in Notification preferences so these findings
reach you daily rather than at month end. Both represent revenue you lose by doing nothing.
