Axxess Hospice now provides a feature that streamlines claim creation and submission by automatically generating recurring claims. Users can set the claim frequency in a payer’s profile, and the system will automatically generate recurring claims based on the frequency details selected.
By streamlining professional claim processes, this feature helps organizations prevent claim denials, decrease costs and optimize revenue cycle management.
To set up automatic recurring claims, users must have permission to view and edit insurance/payer information in Axxess Hospice.
To give a user permission to view and edit insurance/payer information, edit the user’s profile and navigate to the Permissions tab. In the Administration section, select View, Add and Edit next to the Insurance/Payers permission. Click Save to finish granting the permissions.
People tab ➜ People Center ➜ Edit ➜ Permissions tab ➜ Administration ➜ Insurance/Payers ➜ View/Add/Edit ➜ Save
To set up automatic recurring claims for a payer, navigate to the list menu in the top right corner of the screen and select Insurance/Payers from the drop-down menu. Add a new payer by selecting Add Insurance/Payer or edit an existing payer by selecting Edit under Actions.
On the Information tab, select Professional (CMS-1500) under Bill Type.
Once the bill type is set as professional, a new Automatic Recurring Claim section will appear on the Billing Information tab in the payer’s profile. By default, users can set the claim frequency for hospice claims in the Automatic Recurring Claim section.
If the payer also accepts room & board claims, click the box next to Room & Board Payer under Room & Board Settings to set the frequency for room & board claims.
To set the frequency for hospice claims, complete the fields under Hospice Claim Frequency.
Select one of the following options from the Place of Service drop-down menu. Based on the option selected, the corresponding claims will generate according to the selected frequency, and the required service location code will populate to the payer’s claims automatically.
|Place of Service Options|
|12 – Home|
|31 – Skilled Nursing Facilty|
|32 – Nursing Facility|
|34 – Hospice|
Under Frequency, select an option to determine how frequently the system will generate claims. Users can select from the following frequencies:
|Weekly||Claims are generated each week based on the last day of the billing cycle selected. Ex: Billing cycles end each week on Thursdays. Claims will be generated the day after each cycle ends.|
|Biweekly||Claims are generated every two weeks based on the last day of the billing cycle selected. Set a date as the first day of the billing cycle for initial claims to generate. Ex: Billing cycles end every other week on Thursdays starting 10/01/2020. Claims will be generated the day after each cycle ends.|
|Monthly||Claims are generated each month based on the last day of the billing cycle selected. Ex: Billing cycles end on the 15th of each month. Claims will be generated the day after each cycle ends.|
|Semimonthly||Claims are generated twice a month based on the last day of the billing cycles selected. Ex: Billing cycles end twice monthly on the 1st and 15th of each month. Claims will be generated the day after each cycle ends.|
Based on the selected frequency, users will be prompted to select the first and last days of the billing cycle. Complete the fields and click Save to finish setting up automatic recurring claims for the payer.
Updated on 9/17/2020