Conditional Patient Responsibility - Limit Detail

Bridge has rolled out an update (backward compatible) for Conditional Patient Responsibility. Two new dimensions have been added to refine the “limit”.

  • limitPeriod defines the period in which the limit value applies
  • ANNUAL (Jan 1 to Dec 31)
  • BENEFIT_YEAR (Patient-specific benefit cycle)
  • limitMetric defines the metric (units) that the “value” describes
  • VISIT 1 “value” is 1 visit, of a normal duration
  • UNITS 1 “unit” is a billing unit, the conversation of “unit” to “minutes” of a visit is determined by the CPT code

These fields are available immediately. Existing fields are unchanged. Existing behavior has assumed period = ANNUAL and metric = VISIT . These are the only values you will receive today.

See the Testing documentation for new Sandbox Member ID values that resolve with these values, and updates to the CPR documentation for information.

Going forward - we’ll consider any additional changes to this (new limit period or metric types) to be a breaking change, and share details and timings of that in advance.