CHANGELOG
What's new in BillSentry
Product, API and regulatory updates, as they ship.
-
API: Automatic OPCERT lookup from Medicare Number
The API can now work out the OPCERT from the facility's Medicare Number when you don't send one, and accepts OPCERT values with a trailing letter.
The API can now work out the OPCERT from the facility's Medicare Number when you don't send one, and accepts OPCERT values with a trailing letter.
- added: The Medicare Number to OPCERT crosswalk is now applied automatically. If you provide the facility's Medicare Number and no OPCERT, the API uses the crosswalk to determine the OPCERT number in almost all cases.
- changed: OPCERT now supports the trailing alpha character. Values such as 5153000H can be passed as-is, and the suffix is handled internally. The maximum length of OPCERT is now 8 characters (was 7).
Migration: It is still preferred to send the OPCERT number, but when absent a Medicare Number can be used in almost all cases, and you no longer need to remove a trailing letter from the OPCERT.
-
Regulatory & Compliance: Arkansas outpatient fee schedule and by-report documentation
Arkansas outpatient bills are now priced using the Arkansas outpatient fee schedule. Stand-alone revenue codes are disallowed on outpatient and surgery center bills, and Arkansas professional by-report codes need documentation before they can be paid to charge.
Arkansas outpatient bills are now priced using the Arkansas outpatient fee schedule. Stand-alone revenue codes are disallowed on outpatient and surgery center bills, and Arkansas professional by-report codes need documentation before they can be paid to charge.
- fee-schedule: Arkansas outpatient: added support for the Arkansas outpatient fee schedule. Codes on the fee schedule that have no allowance are paid at 95% of charge. Codes that are not on the fee schedule are paid at 100% of charge.
- rule: Arkansas outpatient and surgery center: stand-alone revenue codes are disallowed.
- rule: Arkansas professional: by-report codes must have documentation before they can be paid to charge. Use the Documentation input on the line to mark it as provided.
-
Bill Analyzer: Line Details panel with Line Inputs, quick set and column controls
You can now enter extra values on each service line, such as invoice cost, tax, prior authorization and compound details, and send them to the review with the bill. The Services grid also gains a quick-set shortcut, optional input columns, and column resizing that is remembered.
You can now enter extra values on each service line, such as invoice cost, tax, prior authorization and compound details, and send them to the review with the bill. The Services grid also gains a quick-set shortcut, optional input columns, and column resizing that is remembered.
- added: Line Details: the panel beside the Services grid now has two tabs. Breakdown shows how the selected line was priced. Inputs lets you enter extra values for that line.
- added: Line Inputs: invoice cost, shipping and handling, tax charged, tax rate, prior authorization, documentation, days supply, dispensed as written, refill, compounding time, compounding fee, sterilization fee, container count, quantity override, two-surgeon percent, rendering NPI, chargemaster code, compound ID and sterile compound. These are saved with the bill and sent to the review. Tax allowance is shown for reference and is filled in by the review.
- added: Empty means empty: an input you have not entered shows as a blank box or cell, not $0.00 or 0%. Tax allowance shows a dash until the bill has been reviewed. A quantity override of 0 does show as 0, because 0 disallows the line.
- added: Inputs column: lines that have inputs show them in a new Inputs column in the Services grid. One or two inputs are shown as short tags, three or more as a count, and hovering lists every input with its value. Clicking the column opens the Inputs tab. The column appears only when at least one line has an input, or the review needs prior authorization or documentation for a line.
- added: Prior authorization and documentation: when the review needs either one for a line, the line shows PA REQ or DOC REQ and the Inputs tab explains what to do. Choose Authorized or Provided, then review again.
- added: Quick set: press Ctrl+K (Cmd+K on Mac), or click Quick set, and type a short command such as "inv 450", "rate 8.25" or "pa auth" to set an input on the selected line or on every ticked line. Type "-" after the field name to clear it.
- added: Apply to ticked lines: each input in the Inputs tab has a button that copies its value to every ticked line. If the field is empty, the same button clears that input on every ticked line, so you can remove a value from many lines at once. Prior authorization or documentation that the review has marked Required can't be copied to other lines.
- added: Columns menu: show any input as its own column in the Services grid, from the Columns button or from the column icon beside each field in the Inputs tab. New columns are added just before Reason Codes, and added columns are marked with a purple header. Your choice is remembered in your browser.
- added: Help links: the Bill Analyzer page header has a "How the Bill Analyzer works" link, and the Line Details panel has a Help link. Each opens the Help Center straight on its own article.
- added: Compound drugs: lines that share a compound ID are kept in step. Changing a compound fee, sterilization fee, container count, compounding time or the sterile setting on one line updates the others, because the review uses the highest value across a compound.
- added: Rendering NPI must be exactly 10 digits. Spaces and hyphens are ignored, so 123-456-7890 is accepted.
- changed: Tax rate: leave it blank and the review looks up the rate. After a review, the field shows the rate that was used. Enter it as a percent, such as 8.25. Rates with up to three decimal places are kept exactly, so 8.875% is no longer rounded.
- changed: Duplicating a line now copies its inputs, except money amounts and quantity override.
- changed: Allowance Breakdown panel is now Line Details. One collapse button at the top right of the panel works for both tabs. The message shown when a bill has changed since its last review now fits on two lines.
- changed: Line Details height: both tabs now grow to fit their content, and the Services grid grows with them, up to the height of your window. Anything longer scrolls inside the panel, so a bill with many rule steps no longer makes the page very tall.
- changed: View rule source: on each rule step it now shows which site the link goes to, and flags PDF and Word files, which download instead of opening as a page. A new Copy link button copies the exact link, including the part that highlights the passage on the page, so you can paste it into an email or a dispute response.
- changed: Services grid: the Description column can now be made much narrower, which keeps Charge and Allowance in view when the panel is open. Drag the edge of any column header to resize it, or drag a header to move it. Resized widths are remembered in your browser, and the Columns menu has a Reset widths button. Column edges are now easier to see, and the Enter key follows the order you arrange the columns in.
- fixed: Services grid: columns you moved snapped back to their original place the next time you clicked a row. They now stay where you put them.
-
API: Claim history DTO changes (v1.1.0)
Claim history is now passed using dedicated history DTOs. Some field names have changed and the old names are no longer read.
Claim history is now passed using dedicated history DTOs. Some field names have changed and the old names are no longer read.
- breaking: BillReviewRequestDTO.BillHistory is now List<HistoryBillInfoDTO> (was List<HistoryBillDTO>). HistoryBillDTO has been removed.
- breaking: ServiceDTO.Historical_QuantityUsed, Historical_ServiceState and Historical_BucketTotalList are removed. Use ServiceHistoryDTO.QuantityUsed, ServiceState and BucketTotalList.
- breaking: BillDTO.Historical_BillReviewState is removed. Use BillHistoryDTO.BillReviewState and BillHistoryDTO.JurisdictionState.
- added: HistoryBillInfoDTO holds the historical Bill (BillHistoryDTO), Services (List<ServiceHistoryDTO>), ProviderTaxID and ProviderNPI.
- added: ProviderDTO.MedicareNumber (max 6 characters). Used when BillDTO.MedicareNumber is blank; if both are provided, the bill's value is used.
- changed: BillReviewState and JurisdictionState on a history bill default to the current bill's values when omitted. Store the values returned in BillResultDTO and send them back with future history.
- changed: Sample app: request and response text boxes enlarged to handle larger payloads. README updated.
- changed: California: injection code pricing has been reworked. An injection code can now pay at OPPS, Medi-Cal, the invoice amount, Medicare Part B, or the billed charge, depending on whether the bill is hospital outpatient, surgical center, or another setting. Allowances for California injection codes may change.
- fixed: California: corrected the markup calculation that was reported on California bills. The injection code rework above was needed because both used the same pricing logic.
Migration: If you do not send claim history today, no action is needed. When you do, use the new classes and field names listed above. Old field names are ignored rather than rejected, so QuantityUsed is treated as 0 if the old names are still sent, which can affect limit rules that look back at claim history.
-
Bill Analyzer: Services grid and Bill Analyzer usability improvements
A round of usability improvements to the Services grid, the bill totals bar and the editor toolbar.
A round of usability improvements to the Services grid, the bill totals bar and the editor toolbar.
- changed: Services grid: Charge, Allowance and Quantity columns are now right-aligned so amounts line up.
- changed: Services grid: the grid now fills the available window height and scrolls internally on long bills, and stays compact on short bills.
- changed: Services grid: the Description columns resize with the window and give space back when the Allowance Breakdown panel is open, avoiding a horizontal scrollbar. Hover a description to see the full text.
- changed: Services grid: column widths and header text size adjusted for readability.
- added: Tabs with a validation problem now show a red dot, so you can see which tab needs attention before a bill can be reviewed.
- added: The bill totals bar now appears before a bill is reviewed. Billed Charges updates as you enter lines, and review-based values show "Not reviewed" instead of $0.00.
- changed: Toolbar: Review Bill is now the primary button and Save Bill is secondary. The Control Number and Sequence fields have example placeholders.