Agencies with a New York State PROS program face unique challenges, especially when it comes to billing.  TenEleven’s PROS functionality captures all of the elements on a day-to-day basis that will allow eCR™ to do the complicated billing calculations for you.

PROS Functionality

• Billing compliance and automated charge entry driven from clinical documentation

  • Captures the number of hours in program in relationship to the number of services received in a day

  • Ensures compliance for billing combinations for base rate services and component add-ons (number and types of services for add-on charge eligibility)

  • Automated Medicare charges for clients enrolled as Medicare/Medicaid eligible for CT services

  • System generated pre-admission charge and tracking of units if client is converted to admitted status prior to month end

• Coding progress for specific PROS base rate levels at end of month (levels 1 through 5)

• Captures daily time-in-program

  • Clocking an individual in and out of a program multiple times

  • Counts only the hours the individual was actually in the program

• Captures number of services attended by type

  • CRS (Community Rehabilitiation and Support)

  • ORS (Ongoing Rehabilitation and Support)

  • CT (Clinic Treatment)

• PROS specifc forms (in addtion to the NYSCRI form set)

  • PROS Attestation

  • PROS Initial Services Recommendation

  • PROS Admission Decision Note

• Case Record includes all necessary documentation to support PROS eligibility and medical necessity

Read a testimonial from a PROS agency about their experience managing PROS with TenEleven and eCR™ here.