INTERNAL -MediRoutes Only: Updating Rates past 90 Days (to Date) or 180 Days (from Date)

Clients may occasionally negotiate new rates with their brokers, and in certain situations, these negotiations may allow for the new rates to be applied retroactively to previously completed trips.

Here are several important questions to consider asking the client before proceeding with the generation of a code that will enable rate updates beyond a specified timeframe.

1. Have you confirmed with your broker that retroactive rate adjustments are possible?

• Purpose: Before making any system changes, ensure that the provider has already confirmed with their broker that retroactive billing is permissible. Brokers or payers may have specific rules regarding retroactive rate adjustments, so it’s important to ensure there’s no misunderstanding on this front. If they haven’t confirmed this with the broker, the provider might be wasting time and effort on something that isn’t feasible.

2. Do you have a clear understanding of the time window during which retroactive rates can be applied?

• Purpose: Ask if the provider is aware of any time limits imposed by the broker or governing bodies for applying retroactive rates. Many brokers and Medicaid/insurance programs only allow rate changes within a certain time frame (e.g., within the last 30 or 60 days). If the rate adjustments are too far in the past, they might not be eligible for retroactive claims.

3. Do you want to update rates for all trips in the system, or only specific trips?

• Purpose: Clarify whether the provider wants to update the rates for all previously completed trips or just specific trips. If it's only certain trips, you’ll need clear criteria for which trips should be adjusted. This could involve filtering data based on trip dates, service types, or patient needs, depending on how the rates are structured.

Are you ready to move forward? Here is the screenshot clients will see when trying to update rates past an allowed timeframe.

This popup requires a code generated by the following link:

Run the backup password generator 

Enter the 8-digit code (date) that is in the file name 

Example below the date was 5/6/2021 so the code entered was 20210506 (year, month, date).

Click Generate 

 Once the code has been generated Click Copy. This will copy the password to the clipboard. You can then paste the password into an email and send it to the client. 

Here are some examples of when the Password will be required:

On an Active Rate:

After unchecking Indefinite and selecting a To Date backdated past 90 days.

On a New Rate:

After selecting a From Date backdated past 180 days.

or after selecting a To Date backdated past 90 days.