Create Claims UB04 / 1500 / Invoices

farrah@barnestorm.com — Fri, 05 Aug 2022 03:38:24 GMT

The All Other Billing screen is used to create UB-04 and CMS-1500 claims, as well as private pay invoices. We offer a few different invoice options. (NOTE: This screen cannot be used to generate RAPs/NOAs or EOEs for PPS Payers. PPS billing is done only by using the PPS Billing screen.)

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. Optional: Fill in the Billing Format Code and/or Teams.

5. Click Hospice for Hospice patient(s).

6. Click Exclude Paid Claims, Removes all patient/payers from the list if they have a zero balance in the A/R during the from/thru date selected. You would not check this box if billing Replacement Claim.

Exclude Paid Dates: This will remove charges that have a payment posted for the patient/HCPCS/date.

7. Bill Each Month Separately works when you select billing dates spanning more than one month. A separate claim will generate for each month.

8. Select Ignore All Errors if you want to ignore the invalid ICD Codes, Orders Not Back, and F2F Errors. If you do not select Ignore All Errors you may get a list of errors to be correct before the patient shows up on billing list.

9. 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.

10. 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.

11. From the right, upper corner select which charges you want to include on the claim: visits, supplies, other charges or flu shots. Supplies will select medical supplies with a revenue code of 0270. Other Charges will select all other services that are not visits or supplies. You also have the option to bill for particular disciplines: PT, OT, ST, SN, HHA or SW. NOTE: When flu shots are selected, no other item should be checked.

12. Dates These Charges Were Keyed: This will default with the From date the same as the billing From date and the Thru date as today. Modify these dates only if you want to capture charges that were keyed during a select time frame. This helps to select late entry charges when a week or month has already been billed. Include Modified Charges = When checked it will include any charges that were added or modified during your Keyed date range. When it is not checked it will only include charges added during the time frame.

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

14. Click the Details button to see the charges ready for billing. If clicking the Details button, there is also a checkbox option to "Show Time in, Out." Click the Summary button to see the summary of charges to be billed. If clicking the Summary button, there is also a checkbox option to include "HCPCS detail on Summary." which will divide out the Rev Codes and HCPCS instead of grouping them together. 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.

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

Creating UB-04 or CMS-1500

16. If you are creating a UB-04 or CMS-1500 claim, click on Create HIPAA Tx. Print the list of claims created and then click on Close. 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.

17. Click on the Print UB04/1500 Claim Forms button that appears. 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 on the Print button to print the form.

Creating Invoices for Private Pay

18. 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.

19. 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.

20. 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 for all non-PPS payers. It totals up the charges and marks them as Amount Billed in the AR.

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

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

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

24. 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.

25. 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.

Knowledgebase

Create Claims UB04 / 1500 / Invoices