Unable to determine the fund source or the fund source has been exhausted. Please contact the State Agency responsible for your claims funding to verify available funds.
The first thing to check here is whether or not there is in fact any funding available to bill for. The availability of funding is the responsibility of the State Agencies that use STAR, not STAR itself. If you are unsure whether funding is in fact available, please check with your State Agency contacts first:
For CYFD, contact Patricia Archuleta: patricia.archuleta@cyfd.nm.gov
For BHSD, contact Lisa Salazar: lisa.salazar2@hsd.nm.gov
If you know for a fact there should be funding available, next check some basic aspects of the claim. If you notice anything amiss, correct and resubmit. Things to look at in particular, for this error:
The main billing facility / NPI
The client’s name and ID number
The client’s diagnosis (diagnosis affects whether mental health or substance use funds are used)
If everything seems to be correct, please contact Falling Colors Support, and we will take a look at what might be going on.
One or more clients associated with this service have mandated data that has not been updated within six months. Or, if a timely check-in was completed, it is lacking a diagnosis code.
The first thing to check here is the Mandated Data tab in the client’s record. The most recent entry should be either Initial Registration, Reactivate Client, or Check-in - make sure there is at least one entry, it’s up-to-date, and the client is not deactivated.
You’ll be able to see in the top-right whether a check-in is due or not - make sure the record is not past due. If so, fill out a new check-in.
If the Mandated Data is up-to-date, then the issue is that the most recent Mandated Data is lacking a diagnosis code. If this is the case, when you check the most recent mandated data entry, there will not even be a field to enter a diagnosis.
This could be for one of two reasons:
The client is not Activated in the relevant claims project. You can easily fix this in the record’s Projects tab by clicking Activate.
In some rare cases, the user entering the Mandated Data doesn’t have full access to the claims project. Make sure anyone updating information for client records you are billing for has full access to the claims project in STAR.
This service exceeds the maximum allowable units per day.
If your claim has an acceptable amount of units, then what this error message is telling you is that you have exceeded or met the allowable units in other claims - please check your Claims History under the same client ID to verify.
The rendering provider is not registered at this location - or - Rendering provider was not active at this location when service was rendered.
All rendering providers must have an active account in the Staff section of the Vendor Administration dashboard.
You will need to activate each staff member before you can bill for their services. If you get this message, this means either:
The activation is missing. Bring up the staff record. Then, submit an activation for the staff member at the relevant site in the Update Staff Status section to enable this staff member for billing.
The activation is missing for the correct site. A staff member may be active, but not at the correct facility. Ensure you are selecting the right facility by using the drop-down menu on the right side of the Update Staff Status section.
The date is too late for billing. The provider’s activation date must coincide with or precede the date of service. The activation date should reflect the time the provider began providing services at that location, not the date that the staff record was created in STAR. To change this, all it requires is to add the needed activation record. The system is set up for you to have multiple activation records for the same staff at the same facility, so you don’t need to delete the old one if you do not wish to. STAR will be looking at the earliest date.
Outside timely filing restrictions
This means that the service date of the claim or encounter occurred before the earliest date you are currently permitted to bill for. In order to adjust this, you will need to request the billing window to be opened temporarily.
For the vast majority of users, the earliest date you can bill is the 1st of the previous month. Notable exceptions would be UNM claims submission and ASURE providers.
The fee schedule could not be determined.
Though this message mentions the fee schedule, the issue here is usually staff licensure. STAR is looking at the service and the list of possible licensures a provider can have to include their service on the claim. If the current licensure is not on that list, the claim won’t go through, and you’ll get this error.
To remedy this, either check your Fee Schedule or have your agency’s vendor administrator check for you. The Fee Schedule feature will allow you to search by procedure number. Once you have looked up the possible licensures for the procedure in question, you or someone will need to visit the Staff tab and check to make sure the rendering provider has one of those possible licensures. If not, you will need to add it.
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