The All Other Billing screen is used to create CMS-1500 claims, as well as private pay invoices. 

1.  Click the Billing button from the main menu.

2.  Click the All Other Billing item at the top left of the screen.

3.  At the top middle of the screen, select the From and thru dates for the period you wish to bill.

4.  Below the dates, type in the numbers for the Programs and Payers you wish to bill. You will use this area to isolate which claim you want to bill. For example, you might want to select Programs and/or payers to go to just Eastpointe. Or, just for one DSS location, for example.

5.  Click Exclude Paid Claims, if you want the list to include only Unpaid claims.  You would not check this box, if billing Replacement Claim.

6.  Optional: By default, this process will find errors in your records, such as invalid ICD Codes. We recommend using this feature, as it can find important billing issues before you send a claim. However, if you don't want to see the errors, you can click Ignore All Errors.

7.  Click on the Select Patients as Specified Above button in the middle of the screen. It will take a moment to process the patients that match the program(s) and payer(s) you entered. Then, the chart numbers and names will appear on the left side of the screen in the Selected Patients section. The patients who show up in the list are active patients during the billing time frame you select.  If they show up on the list it does not mean they have chargeable visits entered. To remove claims not ready to be billed:

• In the upper left, click on the chart number of any claim you do not want to include in billing.
• The chart number will move to the bottom center of screen.
• If you change your mind, you can click the chart number in the bottom center section, and it will move back to the upper left, which is the list of claims for billing.

8.  If you only have one patient to bill for, you can enter the chart number or patient name in the Search by Name or Chart Number field. This will add the patient under the Selected Patients.

9.  From the right column, select Prepare Charges for Billing. You will notice extra buttons appear in the right column. Errors/Detail/Summary allows you to view a detail or summary report.

10.  Click the Details button to see the charges ready for billing. Click the Summary button to see the summary of charges to be billed. Click the Errors button to view the errors report again.  From the summary screen, you may click the Print button if you wish to print this information.  Check the HCPCS detail on Summary box to divide out the Rev Codes and HCPCS instead of grouping them together.

11. Click the Hide button in the upper right to go back to the billing screen.

Creating UB-04 or CMS-1500

12. If you are creating a CMS-1500 claim, click on Create HIPAA Tx. Print the list of claims created and then click on Close.  

13. The serial number and location of the claim shows up at the bottom of the list. If for some reason you closed this list before printing, you can select the Re-Print List of Claims to print that list.

14. The claims on this list are the ones you will upload to the MCO on their website. Follow the MCO's instructions to complete that step.

15. If you wish to print the CMS-1500 forms, click on the Print UB04/1500 Claim Forms button.  You will be directed to the Print UB04/1500 screen.  If you are printing them on an actual form - add the forms to your printer. Click on Print All Claims in This Batch or select one patient and click on Print the Select Claim. You may need to adjust the top and left margins on printer in order for text to line up in the fields. Click the Print button to print the form.

Creating Invoices for Private Pay

 16.  Click the Print Patient Statements to generate an invoice.This invoice includes the visit date, hours, job code/visit code description and the amount.

NOTE:  In order for the payers address to appear on the Patient Statement (Bill To section) and not the patient's address, go to the Referral>Payers tab.  At the bottom of the screen "Insured Information" is where you will enter the payers address.  Hit Save All Patient Data.

Minimum Info in Headings = Takes off the doctor, payer name, provider number, HIC# and admitted date.

Print Invoice Numbers = This will add an invoice number to the top of the invoice.  The sequence is based on the month of the billing, ex. 130830001 for August 2013 the first invoice.  The invoice number is NOT assigned to the patient's AR history. 

Include A/R Balance + Transactions = Will add any of the past payment and balance.

Include A/R Comments = Will include any comments used in the AR payment history.

Print Employee Name = Shows the employee who completed the visit.

Combine Multiple visits/day = Joins the daily totals together on one line, adding the hours/units and charges.

Use Payer Address = When the Codes > Program Related Codes > Payer Codes > Contact Information has a Mailing Address filled in, then the Print Patient Statements will show the payer address in the upper left corner of invoice. 

17.  Print Patient Claim Data also includes the revenue codes and HCPCS, along with the visit/job code description, employee, date, hours, units and charges.  The options (min headings,print invoices, etc) above this button do not impact the preview.

18.  04.03 UNBPRNT3 Summary of Patient Charges is just that - a summary of hours, visits, units, charges per patient and discipline. 

Post Billing to AR

****This next step needs to be done after billing is complete.  It totals up the charges and marks them as Amount Billed in the AR.  

1.  After billing is complete and all entries have been verified and corrected, exit from Billing and click on A/R tab.

2.  Click on Post Charges to A/R. Change the Month of billing to be Transferred.

3. You may enter one chart number or leave blank for all.You may enter the Program and Payer code or leave blank for all.

4. If this is the second time you are posting amount billing for the month selected, click the Drop Balances Previously Posted first.  A message asking if you want to drop x number of posting, click yes.

5. Click on Create to view a list of patients or a summary of payers. If the list appears correct you may Print the list then click on Transfer to A/R.