Chart Audit for End of Episode Claims

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Chart Audit for End of Episode Claims


The chart audit helps track PPS episodes that have been audited and are ready for billing. It verifies that visits match ordered frequencies. Use the Billing > PPS Billing > End of Episode Claims and Billing > PPS Billing > Edit PPS Episodes screens for this feature.

  • End of Episode Claims Screen: Print selected episode audits.
  • Edit PPS Episodes Screen: Mark episodes as approved and ready for billing.

Steps to Run the Chart Audit:

  1. Access the Screen: Go to Billing > PPS Billing > End of Episode Claims.
  2. Select Episodes: Use the right-bottom panel to choose episodes for the audit.
    • Program and Payer: Enter specific program and payer, or leave blank to select all episodes.
    • Episodes Thru Date: Specify the date range for episodes.
  3. Select Episodes for Audit: Click this button to list patients meeting your criteria. Remove patients by clicking their name if needed.  
  4. Print Chart Audits: Click to generate a chart audit for each patient. Audits may span multiple pages depending on episode length and data volume.

Report Options:

  • First Day of Audit Week: Set the start day for the calendar view.
  • Print Calendars: Check to print a calendar view of each patient’s episode with discipline abbreviations on visit dates. Leave unchecked to skip this.
  • Mark Audit Printed: Check to mark the episode as printed in the Edit PPS Episode screen, updating the print date. Each print replaces the previous date.
  • Skip If Audit Previously Printed: Check to exclude previously printed audits, avoiding duplicates.

The audit will include:

  • Orders: Discipline frequencies from box 21 of the 485 and verbal orders. Ensure frequencies are in the correct format. Troubleshooting guide.

  • Visits: Lists chargeable and non-chargeable visits by job code and date. Non-charge visits show an amount of 0.00.

  • Calendar: If enabled, prints a calendar format with discipline abbreviations on visit dates. Non-charge visits follow a forward slash.

  • Week-by-Week View: Shows the number of chargeable visits by each discipline per week, helping verify frequencies.

  • Supplies: Lists box 14 supplies and DME orders from the 485, plus itemized supplies entered in Barnestorm.

Completing and Approving the Audit:

After completing the audit and documentation:

  1. Mark as Approved: Go to Billing > PPS Billing > Edit PPS Episode. Select the patient and episode. Enter the auditing employee and click Mark as Audit Approved and Release for Billing. This updates the audit approval date.

  2. Filter Claims: Use the Audit Must Be Complete option on the End of Episode Claims screen to select only episodes with completed and approved audits for billing.

Printing Status Reports:

Print a report showing each episode’s status from Billing > PPS Episode > End of Episode. Enter the program and payer or leave blank for all. Specify the Episodes Thru Date and click Print Audit Status Report. You can print in landscape or export to Excel. This report includes:

  • Episode information
  • Audit print date and age
  • Audit approval date and age
Billing > PPS Episode > End of Episode

Billing > PPS Billing > Edit PPS Episodes



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Details
Last Modified:Monday, June 24, 2024

Last Modified By: farrah@barnestorm.com

Type: HOWTO

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