The state of NJ sets penalty interest percentages on a yearly basis beginning January 1st and ending December 31st. Those percentages are contained within a calculation method automatically applied by Decision Point based on the dates of service within the effective period of the interest percentage. AI user will not see the calculation method anywhere in the product but instead will only see the result.
Here are the key points of the Development effort in Decision Point:
Per NJ statute – interest penalties must be calculated for all $$ owed on a bill after 60 days from date of bill receipt. The non-penalty days may be extended from 60 to 105 if additional information is requested from the provider. Interest % have been changed by the state on a yearly basis and effect all calendar year calculations.
Decision Point functionality:
· A configurable option to activate NJ Penalty Interest calculations will be available to be set globally (applying to all offices) by an Admin User
· A configurable option to add additional days to the interest calculation will also be made available at the global setting (user may wish to account for additional penalty days between when the EOB is available and the actual mail date of payment)
· Interest calculations are automated in Decision Point, the system will use the Date Received (from Bill Screen) as the start date and uses the Analyze (and Save) date as the initial end date (date at which the system uses to end calculations).
o Interest however is automatically re-calculated using a new end date anytime a financial field is adjusted, PPO repricing occurs, a bill line is overridden, copay or deductible are adjusted, or the bill is Committed and Saved. So the end date moves when new pricing occurs (since its assumed the bill isn’t paid yet).
o Interest will also be re-calculated when a Reconsideration occurs (on the reconsidered $$ using only the time the new $$ was owed).
· Two configurable options will be available via the NJ Tab on the Bill Screen – ‘Extend NJ Payment Period’ (allows a user to extend the payment period from 60 to 105 days) or ‘Suspend Interest’ (allows a user to suspend interest calculations on the current bill)
· A third option is also added to the NJ Tab on the Bill Screen – “Additional Information Received” (open date field) When the default setting is active, Interest will not be calculated if the bill is Analyzed or Committed within ten business days of the date entered in this field. Interest is calculated if Analyze or Commit occurs greater then 10 days from date entered in this field (beginning at 60 days past the original date received. An alternative rule set at the global level allows interest to be generated after 10 business days of the date entered in this field regardless of the date bill is received.
· The user may Override the interest at the Bill Level
· The user may Override the interest at the Bill Release Screen level
· The EOB will reflect the a new Interest field (as a subtotal) and the interest will be added to the final Total (owed)
· The EOB will reflect the Date Received, Interest Calculation Date (when then penalty period begins) and the final Calculation Date (when the penalty period ended).