NV Billing: Not Okay to Bill Reasons Guide

This information provides an easy to use guide on how to clear out issues that you may see in the "Not Okay to Bill" and how to resolve them.

Please remember before you begin your review process, perform the "Update" in the create invoices screen.

Not Okay To Bill Reason	Agency Action to Correct
Authorization is Missing	Review the client's profile to ensure that there is a valid authorization for the time period in question. Ensure that the authorization limitations are being followed correctly. If there is no authorization the agency will need to contact the client's payer to have them send Sandata this information.
Authorization Reference No. is Missing	Review the client's profile to ensure that there is a valid authorization for the time period in question. Ensure that the authorization limitations are being followed correctly and contains an authorization reference number. If there is no authorization/ref # the agency will need to contact the client's payer to have them send Sandata this information.
Missing DOB	This information comes through your client feed from the client's payer. Please outreach the state at [e-mail] to have the DOB corrected and resent.
Missing Employee NPI	Access the Employee's profile and on the bottom of their Personal tab is a space to add in their NPI number.
Missing Primary Physician	Go to the clients profile and access the Program Tab. On the right hand side there is the option for adding in the Primary Physician and their respective information.
Missing Proposed Times	Scheduling is optional for the NV program so this should not be a message that is seen. If this pops up please reach out to Sandata at 833-545-0394 for further review.
Missing SOC	Go to the Client's profile and add a Start of Care (SOC) date on their Program tab. Make sure this is entered as the day this client started services with your agency.
No Amount Calculated	Review the client's profile to ensure that there is a valid authorization for the time period in question. Ensure that the authorization limitations are being followed correctly. If there is a discrepancy on the visit vs. the auth this could cause no calculation to occur.
No Rate Defined for Service/Event Code	Ensure that the authorization matches the visits with the bill type and service and event code assigned to the client. If this matches please outreach Sandata at 833-545-0394 for review.
Physician Missing NPI	Go to the clients profile and access the Program Tab. On the right hand side there is the option for adding in the Primary Physician and their respective information.
Primary Diagnosis is Missing	This information comes through with your client's authorizations. If a diagnosis code is missing please outreach your client's respective payer to correct and resend.
Quantity is Zero	Review the client's profile to ensure that there is a valid authorization for the time period in question. Ensure that the authorization limitations are being followed correctly. If there is a discrepancy on the visit vs. the auth this could cause no calculation to occur.
Unconfirmed Shift for This Day	Review Visit Maintenance for this date of service and this client. Make sure that all visits performed on that given day have been verified and if the second visit does not need to be billed, mark the selection as do no bill.