Claims priced on the rate that applied that day
A price guide changes and last month's claims are suddenly wrong. CareBuddie stores the price guide version on every line and prices it on the date of service, so a rate change cannot reach backwards into a batch you already submitted.
Request early accessApril 2026 claim batch. 42 line items priced on Price Guide version 26.04, with lines marked paid, ready and under review.
MVP exports a PRODA-ready CSV for manual bulk upload. Live PRODA/PACE API submission lands in Phase 2.
A rate change cannot rewrite history
Price guide rates are insert-only. A new effective-date row is added; the old one stays exactly where it was. Every claim line records the version it was priced on.
- Insert-only rates · A rate is never overwritten in place. A new effective-dated row is added.
- Date of service pricing · Each line is priced on the rate in force the day the support happened.
- Version on the line · The price guide version is stored on the claim line itself, not inferred later.
Rate history for one support item. Superseded rows are retained, never edited.
A rejected line stays visible until somebody fixes it
Exporting is the easy half. Mark a batch submitted, then mark each line paid or rejected. Rejected lines stay flagged on the dashboard rather than quietly disappearing.
- Batch states · Draft, submitted, then paid, partially paid or rejected. Terminal states are enforced by a database trigger, not a convention.
- Line-level outcome · Each line is marked paid or rejected on its own.
- Nothing lost · Rejected lines stay on the dashboard until resolved.
A submitted batch mid-reconciliation. Rejected lines stay actionable.
A bulk payment file you can upload today
The live PRODA/PACE API is Phase 2. Until then, and permanently as a fallback, CareBuddie produces the bulk payment CSV for manual upload.
- PRODA-ready CSV · The bulk payment file, formatted for manual upload.
- Preview before export · A draft batch shows a CSV preview before anything is exported.
- Swappable submission · Live API submission is planned behind the same interface, so the manual export stays as a fallback.
Preview the file on a draft batch, then upload it to PRODA yourself.
Any questions?
What happens when the price guide changes?
A new effective-dated row is inserted. Existing rows are never overwritten, and claims already priced keep the version they were priced on.
Can I submit claims directly to PRODA?
Not in the current release. CareBuddie exports a PRODA-ready bulk payment CSV for manual upload. Live PRODA/PACE API submission is planned for Phase 2.
What happens to a rejected line?
It stays flagged on the dashboard until somebody resolves it.
Can a paid batch be changed?
No. Paid is a terminal state, and a database trigger rejects changes to terminal states rather than relying on the form.
Will the manual export go away when the API ships?
No. Manual export stays available as a fallback.
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