Provider Information
Provider Export Code
N/A
Payment Terms
N/A
Service Types Performed
HHA, PCA
Update Rates to 0 After
300 days
Active with Contract
Yes
Bill Visits without POC Compliance
Yes
Allow Provider to Update Billing Rates
No
Can Change Invoice Export Flag
No
Use Provider Taxonomy Code
No
Use Provider Revenue Code
No
Restrict Rebilling of Original Claims
No
Rates
| Service Code | Unit | Category | Service Type | From Date | To Date | Rate | Rate Type | Status | Actions |
|---|---|---|---|---|---|---|---|---|---|
| [ Service Code ] | - | Home Health | HHA | 01/01/2019 | 01/03/2025 | 19.00 | Hourly | Active | Clone Edit |
| [ Service Code ] | - | Home Health | HHA | 01/01/2019 | 01/03/2025 | 19.00 | Hourly | Active | Clone Edit |
| [ Service Code ] | - | Home Health | HHA | 01/01/2019 | 01/03/2025 | 19.00 | Hourly | Active | Clone Edit |
| [ Service Code ] | - | Home Health | HHA | 01/01/2019 | 01/03/2025 | 19.00 | Hourly | Active | Clone Edit |
| [ Service Code ] | - | Home Health | HHA | 01/01/2019 | 01/03/2025 | 19.00 | Hourly | Active | Clone Edit |
| [ Service Code ] | - | Home Health | HHA | 01/01/2019 | 01/03/2025 | 19.00 | Hourly | Active | Clone Edit |
| [ Service Code ] | - | Home Health | HHA | 01/01/2019 | 01/03/2025 | 19.00 | Hourly | Active | Clone Edit |
| [ Service Code ] | - | Home Health | HHA | 01/01/2019 | 01/03/2025 | 19.00 | Hourly | Active | Clone Edit |
| [ Service Code ] | - | Home Health | HHA | 01/01/2019 | 01/03/2025 | 19.00 | Hourly | Active | Clone Edit |
| [ Service Code ] | - | Home Health | HHA | 01/01/2019 | 01/03/2025 | 19.00 | Hourly | Active | Clone Edit |
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