Billing Guidelines a. All tasks set forth in Special Counsel’s billing documentation shall be specific and detailed. Overly generalized listings of task descriptions such as “review contract” or “prepare for negotiations” are not acceptable.
x. Xxxxxxxx under this Agreement shall not be provided in more than six (6) minute increments and shall represent the devotion of a full six minutes before an increment is billed. Under no circumstances shall Special Counsel use “block billing” procedures, wherein a list or series of activities is done each day with only an aggregate amount of time specified.
c. Special Counsel shall keep the City advised of the identity and billing rates of those people working on the project account.
d. All time shall be billed within 30 days of the end of the month in which services were performed.
e. Counsel shall advise City whenever it anticipates the amount of services necessary to properly execute the task will exceed the amount of the contract. When accrued xxxxxxxx are equal to eighty percent (80%) of the Payment Limit, written notice shall be given to the City as soon as possible, via e-mail, to the City Attorney’s Office, of this fact. In order to satisfy this notification requirement, Counsel shall monitor its accrued xxxxxxxx on a weekly basis and immediately notify the City Attorney if the eighty percent (80%) threshold is met. Special Counsel acknowledges the fiscal constraints on City funding and therefore Special Counsel assumes risk of non-payment for services rendered in the event the amount of services rendered exceeds the amount of the contract unless prior written authorization is received. Authorization to exceed the amount set forth in Exhibit A may be given only by City Attorney in writing.
f. Only those attorneys approved by the City may bill on the case.
g. The City expects the attorney assigned to the case to handle all significant matters in the litigation. The City Attorney must approve in advance the assignment of other attorneys to the litigation or project. The City may request that the assigned work be instead handled by the primary attorney.
h. Special Counsel shall not charge for more than one attorney at any hearing, deposition, or meeting of any kind without advance approval of the City Attorney.
i. No more than two paraprofessionals may bill on a particular case without the prior approval of the City.
j. The City has retained Special Counsel for its expertise, and therefore expects not to be billed for introductory...
Billing Guidelines. Unless otherwise specified herein the term "unit" in Schedules A and B is defined to mean a fifteen (15) minute episode of service with the client present in compliance with the applicable Administrative Rule. The Mental Health Board shall pay the authorized unit rate for each fifteen (15) minutes of qualifying client Service identified on the Work Plan by service or activity code that has been provided and is properly documented and submitted for payment. An episode of Service lasting at least eight (8) minutes but less than fifteen (15) minutes shall be paid an amount equal to the authorized cost per unit. An episode of Service lasting less than eight (8) minutes shall not qualify for any payment. Units lasting less than 8 minutes shall not be added together to meet the billable unit time requirement. The Mental Health Board will not pay for time spent completing clinical documentation unless completing such paperwork meets the definition of a reimbursable service. The Mental Health Board shall pay the authorized unit rate for each qualifying client service or service code identified on the Schedule B that has been provided and is properly documented and submitted for payment at the time of contract execution. Payments under this Agreement shall be made on a monthly basis within 60 days of submission by the Provider of a satisfactory monthly Affidavit and any related data submission requirements detailed in the program specific Work Plan or Special Conditions. Affidavit submission shall occur within 30 days of the end of the month in which Services were provided, including resubmissions, unless otherwise approved by the Mental Health Board. All Affidavits shall be submitted in accordance with Mental Health Board fiscal year-end deadlines, which will be communicated to Provider during the Mental Health Board’s fourth quarter.
Billing Guidelines. Deleted: 2 Rev – 8/23 Unless otherwise specified herein the term "unit" in Schedules A and B is defined to mean a fifteen (15) minute episode of service with the client present in compliance with the applicable Administrative Rule. The Mental Health Board shall pay the authorized unit rate for each fifteen (15) minutes of qualifying client Service identified on the Work Plan by service or activity code that has been provided and is properly documented and submitted for payment. An episode of Service lasting at least eight (8) minutes but less than fifteen
Billing Guidelines. PBS shall prepare all bills and claim forms for Services provided by Client pursuant to the Billing Guidelines set forth in the attached Appendix B.
Billing Guidelines. PBS, in its sole discretion, shall make all billing decisions, including, but not limited to, decisions on the level of service billed and determination of medical necessity. Such decisions shall be made based on the guidelines, policies and regulations issued by Medicaid, Medicare, or other third party payer.
Billing Guidelines. The HSC includes a review of the patient’s relevant history, relevant family history and relevant history of present complaint, and a review of any laboratory data, PACS images, medical records or other data as needed to provide advice. The health service includes a discussion of the relevant physical findings as reported by the referring provider. The Consultant Physician HSC is not reportable in addition to any other service for the same patient by the same physician on the same day. The Referring Physician HSC may be reported when the communication with the consultant physician occurs on the same day as a patient visit -or other service. The HSC is not reportable when the purpose of the communication is to: - Arrange transfer - Arrange a hospital bed for the patient - Arrange a telemedicine consultation - Arrange an expedited face to face consultation - Arrange a laboratory, other diagnostic test or procedure - Inform the referring physician of the results of diagnostic investigations - Decline the request for a consultation or transfer the request to another physician The service is reportable only when the communication is rendered personally by the physician reporting the service and is not reportable if the service is delegated to another health professional such as: - Nurse practitioner - Resident in training - Clinical fellow - Medical student The service is not reportable for telephone calls or face to face conversations of less than 5 minutes of two way medical discussion. • The referring physician must document that the referring physician has communicated the reason for the consultation and relevant patient information to the specialist. • Both the specialist consultant and the referring provider must document the patient name, identifying data, date and encounter time in their respective charts or EMRs. • The names of the referring physician or provider and the consultant physician must be documented by both physicians. • The diagnosis, reason for referral, elements of the history and physical as relayed by the referring provider, the opinion of the consultant physician and the plan for future management must be documented by the referring physician and the specialist. • A written report must be sent to the referring provider by the specialist consultant. • The referring physician’s billing number must be noted on the claim from the consultant. This is not required for the referring physician’s claim.
Billing Guidelines. Unless otherwise specified herein the term "unit" in Schedules A and B is defined to mean a fifteen (15) minute episode of therapy with the client present or assessment and case management type Services in compliance with the applicable Rule 132 or 2060. The Mental Health Board shall pay the Authorized Unit rate for each fifteen (15) minutes of qualifying client Service that has been provided and is properly documented and submitted for payment. An episode of Service lasting at least eight (8) minutes but less than fifteen (15) minutes shall be paid an amount equal to the Authorized Cost Per Unit. An episode of Service lasting less than eight (8) minutes shall not qualify for any payment. Units lasting less than 8 minutes shall not be added together to meet the billable unit time requirement. The Mental Health Board will not pay for documenting client encounters or for the completion of paperwork and documentation that does not involve direct client contact or Services. The Mental Health Board shall pay the Authorized Unit rate for each qualifying client Service that has been provided and is properly documented and submitted for payment. The unit rate is specified in each Schedule. Payments for the Grant and the Fee for Service Agreements shall be made on a monthly basis commencing with the month of December 2013, payable in January 2014, and each and every month thereafter, upon submission by the Provider of a satisfactory monthly Affidavit and documentation of Services delivered. Provider shall make no change to the Affidavit template supplied without written permission from the Mental Health Board.
