Issue Categories

FinThrive applies a category to an issue during certain stages and statuses of the implementation. Categories help FinThrive to track the reasons for any contract profile rejections, either by the customer or FinThrive. Specifically, a FinThrive analyst in charge of the contract must apply a category to an issue whenever the contract status is “rejected” in one of the following stages:

FinThrive Audit
Client Audit

For more information about implementation stages, refer to Implementation Stages.

The following table explains Product Issue categories.

Category	Description
Billing Practices	The facility bills a service type differently than indicated in the profile
Contract Interpretation	There is a difference of opinion about the interpretation of contract wording
Incorrect Attributes	The service type has incorrect attributes, such as the wrong DRG, revenue code or days expression
Incorrect Calculation	The calculation method appears to be incorrectly loaded
Incorrect Fee Schedules	The wrong fee schedule (for example, ICD, DRG or CPT schedule) is associated with the contract
Incorrect Terms	The rate loaded in the system is something other than what is in the contract
Invalid Rates Loaded	The rates are defined incorrectly in the system according to the contract; for example, the contract rate should be loaded as 60%, not 75%
Missing/Extra Svc Types	There are missing or extra service types in the Contract Profile
Missing/Outdated Fee Sch.	A fee schedule is missing or there is an outdated fee schedule in the system
Missing/Outdated Fee Terms	One or more fee terms are missing or outdated
Research/Clarification	A calculation or system definition needs clarification
Not Categorized	This is not selected as a category, but is the default if no category is assigned

The following table explains Facility Level Issue categories.

Category	Description
Adjustment File	The issue involves the adjustment files received from FinThrive
CBO Errors	The issue involves the CBO system
Contract Implementation	The issue is implementation-related
Data	The issue involves the data in the system
Data Acquisition	The issue involves acquiring the data used in the system
Import Job	The issue involves an import job
Internet	The issue is Internet-related
Medicare	The issue involves Medicare or other government payors
Queries	The issue involves queries
Reports	The issue involves reports
Reprice Error	The issue involves one or more reprice errors
Reprice Job	The issue involves a particular reprice batch or job
Request Enhancements	The issue suggests an enhancement to the system
Contract Modeling	The issue involves Contract Modeling or Contract Loading
Not Categorized	This is not selected as a category but is the default if no category is assigned