Agencies encountering scenarios which delay the ability to
submit claims on a timely basis may use the Enter Extraordinary Circumstances screen in EIBilling for requesting an extension, or ‘relief’, from timely filing
requirements.
This article illustrates commonly seen instances and
subsequent resolution to guide the agency in making the most efficient use of
this process.
Extraordinary Circumstances (ECs) are not entered on
a per claim, per child, or per service authorization basis. Rather, they are entered
once for the entire overlapping date range the agency is affected and should be
entered within 30 days of relief date.
As defined, the event date is the first date the agency lost
their ability to submit claims, and the relief date is the first date the
agency regained their ability to submit claims.
The agency could have one (1), ten (10), or even 100
children; as long as each child, claim, or authorization was impacted by the same event, only one (1) EC is required that covers the entire date range. Examples are
defined below.
Example 1: The agency has four (4) children with
claims they were not able to enter within 90 days.
|
Child
|
First Claim
Date
|
Last Claim
Date
|
|
A
|
4/5/21
|
5/5/21
|
|
B
|
4/6/21
|
4/13/21
|
|
C
|
4/6/21
|
6/6/21
|
|
D
|
4/7/21
|
6/11/21
|
Example 2: The agency has one (1) child with three
(3) claims they were not able to enter within 90 days.
|
Claim Date
|
|
5/5/21
|
|
5/6/21
|
|
5/10/21
|
Example 3: The agency has four (4) different service
authorizations with claims they were not able to enter within 90 days. It could
be four authorizations for one child, one authorization each for four different
children, or a different mix.
|
Child
|
Authorization
#
|
Start Date
|
End Date
|
|
A
|
1111111
|
2/5/21
|
5/5/21
|
|
B
|
1111112
|
3/6/21
|
6/13/21
|
|
B
|
1111113
|
4/6/21
|
6/6/21
|
|
C
|
1111114
|
4/7/21
|
6/11/21
|
Resolution: In each example, if the relief date is
9/20/21, the agency would only enter one (1) EC with the event date reflecting
the first date the agency lost their ability to submit claims, and the relief
date of 9/20/21 (or up to 30 days prior to relief date, if applicable) reflecting the fist date the agency regained their ability to submit claims. Multiple
entries are not required for each child, claim, or authorization.
For additional information on how to enter ECs, please
follow these Knowledge Base links:
https://support.eibilling.com/KB/a402/90-day-claims-submission-deadline.aspx
https://support.eibilling.com/KB/a404/90-day-claims-submission-qa.aspx
Article ID: 453, Created On: 9/29/2021, Modified: 9/29/2021