Understanding FHO+ Billing Errors (rejection codes)

Understanding FHO+ Billing Errors (rejection codes)

Hourly rate billing rules

  • The health number, version code and birthdate fields on the claim must be left blank
  • When an hourly code is submitted without a blank health number field the claim will reject 'VHB – No HN required for HSC'
  • When an hourly code is submitted without a blank version code field the claim will reject 'VHB – No HN required for HSC'
  • When an hourly code is submitted without a blank birthdate field the claim will reject 'VH1 – Invalid Health Number'
  • The service date for any hourly‑rate billing code must reflect the actual date on which the hourly activity was performed
  • FHO signatory physicians can bill hourly codes only with their FHO group number or solo billing number
  • FHO locum physicians must bill hourly codes with their FHO group number
  • FHO income stabilization physicians are not eligible to bill hourly codes
  • When a physician other than a FHO affiliated physician submits one of the new hourly codes the claim will be rejected 'EPA – PCN Billing not approved'