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Billing Center Overview

 

Users with billing permissions may access the Billing center from the main menu.

 

The Billing Menu contains two main categories:

 

The Invoice Menu contains three submenus.

 

Create Invoices

 


Billing-Invoice-Create Invoices

 

Indicate the parameters for the invoice creation:

 

Client invoices that contain an overlapping date range will appear in Orange within the list.

 

Outstanding Invoices


Once invoices are created from the Create Invoice page they move to the Outstanding Invoices.

 

 

The generated invoices display the following summary information:

 

Invoice #, MRN, Client Name, Is Verified, Invoice Date, Due Date, Amt Due, Net Due, and the Invoice date range.

 

In addition, options to Print the Outstanding Invoice List or Export the list to excel exist.

 

Invoices that are unverified have the following actions: the ability to Print, Verify/Edit the Invoice or Delete

 

Click on the client name to open the Invoice for verification.

 

The Edit Invoice page displays the details of the invoice and provides editing as needed.  Required fields are indicated with a red asterisk.

 

The lower half of the invoice will display billing line items.  The columns displayed reflect what is set up in Manage Company Information.

 

Private (self) pay client rates are maintained in the client file.  All others are maintained in the payment source file.

 

The Quantity and Rate are Editable by clicking in the field.

 

The last section provides the ability to add custom service charges.  Click on the Add Custom Service/Tasks to enter the applicable charges.

 

Add any applicable tax

 

Verified Invoices contain a green check mark in the verified column.  Once verified, a selection field is activated and the available actions are updated with additional options of Send and Receive Payment.

 

There are several options available to submit Invoices to Payment Sources:

 

Under Actions:

 

From the Invoice list page:

 

Selecting to Receive Payment displays the post payment window for completion.  This is described in greater detail under the Invoice History page.

 

Invoice History


Billing-Invoice-Invoice History

 

The Invoice History page contains a list of a client's invoices.

 

For convenience, a new invoice may be added by selecting New Invoice at the top of the page.

 

The Expand will expand the list over the invoice summary at the top.

 

Once an invoice is selected:

 

Options under the action column includes:

 

Post Payment contains two required fields

 

Post Adjustment: contains three required fields:

 

Invoice Quick Reports


To the right of the client information are quick reports associated to the invoice selected, allowing the user to view payments and adjustments posted to the invoice as well as an activity log showing when the invoice was updated and by whom.

  

View Payments/Adjustments:

 

 

Activity Log:

 

Claims


The Managed Care/Other Insurances category contains four sub-menus.

 

Create Claims


Billing-Managed Care/Other Insurances-Create Claims

 

Select the branch, payment source/s and date range that you are creating claims for.

 

Then select Generate

 

The system will generate a list of claims that match the requested parameters.

 

Claims identified as having overlapping claim dates will be highlighted in orange.  These claims may be excluded from the list by selecting Exclude Overlapping Claims.

 

Select the claims you wish to create and click Create Claims.  This action move the claims into the Outstanding Claims page.

 

Users may select the quick link Go to Outstanding to navigate to the claim list.

 

 

Outstanding Claims


Billing-Managed Care/Other Insurances-Outstanding Claims

 

The outstanding claim list will display all generated claims requiring verification to bill.

 

The summary list contains the Client Name/MRN/ Claim Date Range and the 4 verification pages of the claim (detail/visit/supply/verified).  The last column is the print icon for viewing and downloading the claim.

 

Clicking on the client name opens the claim for verification.

 

Step 1-Demographics:

 

Required field completion includes:

 

Diagnoses:  A Primary Diagnosis is required.

 

Nonrequired fields include Additional Diagnoses, condition codes, and remarks. Ensure population of these if required by the payor.

 

Step 2-Verify Insurance

 

 

The lower half of the screen displays all rates that have been loaded for the insurance.  You can Add Additional Task Rates or edit/delete existing task information as needed.

 

Step 3-Verify Visits

 

The claim date range displays at the top of the page for reference.

 

Tasks group into categories.

 

If no tasks fit a category the category will not display.

 

Actions include:

 

 

Step 4-Verify Supplies

 

Recorded supplies (billable and non-billable) display and are editable as needed.

 

Step 5-Claim Summary: Provides a summary review of the claim.  Select Complete to finish the verification process.

 

A green checkmark displays when the verification is completed for the pages. Once all checkmarks are present a selection field presents to the left of the claim.

 

Claim submission options depend on the payment source setup.  Options include:

 

Claims History


Billing-Managed Care/Other Insurances-Claims History

 

The Claim History page contains the list of a client's claims.

 

For convenience, a new claim may be added by selecting New Claim at the top of the page.

 

The Expand will expand the list over the claim summary at the top.

 

Once a claim is selected:

 

Available Action Items depend on the claim status. Most include the ability to

 

Post Payment contains two required fields:

 

The claim status will automatically update based on the outstanding balance and includes: paid, partially paid and overpaid

 

Post Adjustment: contains three required fields:

 

Claim Quick Reports


To the right of the client information are quick reports associated to the claim selected, allowing the user to view payments and adjustments posted to the claim as well as an activity log showing when the claim was updated and by whom.

 

View payments/adjustments:

 

Activity Log:

 

Claim Submission History


Billing-Managed Care/Other Insurances-Claim Submission History

 

Claims that are electronically submitted will populate to the Claim Submission History page.  This menu allows the ability to review batches of claims, the response files and the claims within the batch.

 

Select the branch, payment source and date range and select generate to narrow return results.

 

The summary line item displays the Batch Id, Payor, Submission Date, Number of claims in the batch as well as an action column from which the user may elect to view the claims, export the file or view the response.

 

Selecting the expand icon (+) next to the batch will display the list of claims included in the batch. Information includes the Client Record number, Client Name, Type of Bill, Claim Date Range, Date Created, Claim Amount and the ability to view the claim.

 

 

Response File


The response file will provide a summary at the top and then list the claims within.  Users have the ability to close or print upon viewing.

 

It will list the total number of claims submitted along with the number accepted and rejected and provide charges associated with each.

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