Service Rules — Inputs
Inputs define when a service rule fires. If any input criteria are not met, the rule will not run and no service will be generated.
Input Fields
Encounter types: Only encounter types marked as "Billable" in your encounter configuration will appear in the dropdown. If an encounter type is missing from the list, it is not yet marked as billable.
Programs: The client must be enrolled in the specified program at the time of the encounter. Matching is based on encounter start time. If a client was admitted at 12:01 PM and an encounter started at 12:00 PM, the program match will fail.
Level of care: Each program and level-of-care combination is a separate option in the inputs.
Payer groups: Can be configured many-to-one (multiple payers mapped to one group) or one-to-one.
Duration Constraints
You can set a minimum and/or maximum encounter duration as an input gate.
If an encounter exceeds the maximum duration, the rule will not fire — this is intentional behavior, not rounding down.
Duration constraints apply to each individual encounter, not the bundle total.
Useful for hard cutoffs (e.g., "an encounter must be at least 15 minutes to be billable").
Do not use duration constraints when you intend to set a minimum bundled total — see the Advanced Options section for minimum bundled minutes.
"No Active Programs" Setting
Allows a rule to fire for clients who are not currently enrolled in a program. Useful for billing pre-admission assessments that occur before a client is formally admitted. Confirm with your payer whether active program enrollment is required before using this setting.
Admission Date vs. Encounter Date
Service rules require the client to have been admitted before or at the time of the encounter. If the admission date is after the encounter date, the rule will not fire. To resolve this, correct the admission date using the un-admit and re-admit workflow, then rerun billing rules.
Primary Diagnosis and Diagnosis-Based Overrides
If no primary diagnosis is explicitly designated on the client chart, Ritten will default to the first diagnosis in the list when evaluating diagnosis-based overrides. Make sure clients have a primary diagnosis designated to ensure correct rule matching.