Unpayable Visits
Recording work a denied recertification means will never be paid
Care does not stop while Authorizations waits on a recertification. Visits keep happening, and most of the time the approval comes back dated to cover them, so the work gets paid as normal.
Sometimes the recertification is denied. Every date already worked will never be paid, and there is nothing to re-submit. Unpayable is how you record that.
When to use it
Use Unpayable when the payer has closed the door on work you have already billed. The claim went out, the answer came back, and no amount of re-billing will change it.
If the payer rejected the claim for a fixable reason, such as missing information or a wrong code, that is a re-bill instead. Re-bill means try again. Unpayable means there is nothing left to try.
Marking a visit unpayable
One visit:
- Click the billed day (blue cell)
- Hover over the visit and click the maroon Unpayable button
- The visit turns maroon
A whole group on one day: click Unpayable beneath the billed group to write off every billed visit on that day at once.
A date range:
- Drag to select a range of billed days
- In the detail panel, click Unpayable beside Rebill and Mark Paid
- If the range covers more than one billing code, untick any code you do not want to include before you click
What happens next
Three things change, and one important thing does not.
| What | Effect |
|---|---|
| The visit record | Stays exactly as it is. Still logged, still billed, not deleted. |
| Caregiver pay | Unchanged. The visit still counts as hours worked. |
| Money owed | Stops counting. The visit leaves your remittance queue and no longer appears as collectable. |
| Binder totals | The units appear under a separate Unpayable figure so the cost stays visible. |
The caregiver is still paid. A denied recertification means the agency will not be paid for the visit. It does not mean nobody went to the house. Payroll runs off the timesheet, so unpayable visits count toward hours and appear on payroll statements like any other work. The agency absorbs the cost.
Recording why
Most offices add a note on those dates saying what the payer said. Unpayable does not prompt you for one, so add it the same way you add any other calendar note.
If the denial is overturned
Denials do get reversed on appeal. Hover over the maroon visit and click Undo Unpayable. Each visit returns to exactly the status it came from:
- A visit that was billed goes back to Billed
- A visit that was already in the re-bill queue goes back to Re-bill
That distinction matters. A re-bill was still waiting on the biller, and sending it back to Billed would hide work that had not been finished.
Only the Remittance role (and Admin) can mark visits unpayable or undo it. Visits can only be marked unpayable from billed or re-bill. A paid visit cannot be, because the money already arrived.