What are carved-out services, and how should they be billed in Resolute?

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Carved-out services are items not included in the standard payer contracts or pricing arrangements. They sit outside the regular coverage terms, so they must be handled separately from the main claim. In Resolute, you identify these services and route them to the appropriate payer or process them as a separate claim. This ensures the service is billed under the correct arrangement and can be reimbursed accurately, rather than being wrapped into the standard contract billing which could lead to incorrect benefits or denials. For example, a service covered under a distinct carve-out program or by a different payer should not ride along on the standard institutional claim; instead, it’s submitted to the correct payer or created as its own claim.