Reports: Billing

  • Updated

The Billing tab allows you to view and manage all evaluations, group sessions, and labs marked as billable, billed, or do not bill in your location or locations. You can also view and manage batches, view the ledger, and export items to CSV or Excel files. 

Note: If desired, you can work the billing items of a specific patient from that patient's chart. The processes are the same in both locations.

Required Permissions: Users must have Super Admin, Records Admin, or Manage Users permissions to view and use the following areas.

  1. To begin, click Reports > Billing.
  2. If you are in a master instance, you can view billable items by location or for the entire instance by either selecting a location from the header drop-down or choosing My Locations.

Grouping Billable Items in the Same Claim

In order for two or more billable items to be grouped in the same claim, the following items must match:

  • Patient Chart
  • Location
  • Insurance Authorization
  • LOC Type - ie All Ancillary items or All Per Diem items
  • LOC Type of Bill if claim format exists and it’s institutional
  • LOC Value Code if claim format exists and it’s institutional
  • LOC Occurrence Code if claim format exists and it’s institutional
  • LOC Occurrence Span Code if claim format exists and it’s institutional
  • Claim Format
  • Billing Provider
  • Konnector
  • Place of Service

Billable

The Billable tab shows all billable items for your location or instance. 

  1. Use the search fields to find the desired billable items.
    1. Start Date: To return results by start date or date range, click on the field and either use the calendar to select a start date, or type in the desired start date using the MM/DD/YYYY format.
    2. End Date: To return results by end date or date range, click on the field and either use the calendar to select an end date, or type in the desired end date using the MM/DD/YYYY format.
    3. Patients: To return results by patient, enter the first three letters of their first name or last name and select them from the drop-down. 
    4. Payor: To return results by payor, enter the first three letters and select the desired result from the drop-down.
    5. Billing Providers: To return results by billing provider, enter at least the first three letters of their name and select the desired result from the drop-down.
    6. Warning and Errors: Click on this field and choose Hide Warnings and Errors, Show Warnings, or Show Errors to filter results.
    7. Click Search.
  2. Once you have chosen your parameters and clicked Search, you will see a charge row for each billable item (or bundled line item, depending on if you've configured any Payer Rules).
  3. The buttons below the search results can be used to perform the following actions:
    1. Expand All: Click on the Expand All button to expand the details sections of each item.
    2. Collapse All: Click Collapse All to close any/all details sections.
    3. Select All: Select all items ready for transmission.
    4. Select All Don't Bill: Will select all items marked as Do Not Bill.
    5. Select All Grouped: Select all grouped items.
    6. Deselect All: Deselects all selected items.
    7. Reset Filters: Resets filters to the default.
    8. Reset Sorting: Removes any sorting options selected.
    9. Excel: Export results in an Excel file.
    10. CSV: Export results in a CSV file.
  4. You can show items in ascending or descending order by clicking on the arrows next to each column. The Filter fields under the column names allow you to type in any filter options you wish to apply.  
    1. Clicking on the checkbox under Discharge Date once will show only items belonging to discharged patients. Clicking on it twice will show only items belonging to current patients. Clicking the checkbox a third time will re-set the filter.
  5. Clicking on a patient's name will take you to their facesheet.
  6. If an item has a flashing red notification, it indicates that there is missing information in the billing report. Hovering over it will tell you what information is missing. If there is any incomplete information, you will not be able to check off the Select Box.
  7. If an item has a flashing yellow notification, it indicates that information is missing, but that transmission can still occur. 
  8. There are three types of checkboxes you can choose from: Select, Group, and Don't Bill.
    1. Select: Billable items with no errors can be selected.
    2. Group: Billable items for the same patient can be grouped to show up on the same claim.
    3. Don't Bill: If you do not wish items to be billed, select them here. These items will be moved to the Do Not Bill tab.
  9. Click on the edit pencil to edit the claim.
  10. Click on the + to expand the item details.

Billed

The information and filters on the Billed tab function in the same manner as they do on the Billed tab, however, it only shows items that have already been billed.

  1. From the Reports tab click Billing > Billed.
  2. As the items in this tab are already billed, you cannot edit them from this screen.
  3. You can show items in ascending or descending order by clicking on the arrows next to each column. The Filter fields under the column names allow you to type in any filter options you wish to apply.
  4. You can click on the patient's name to view their facesheet and on the status to view more information.
    1. Clicking on the status will take you to the Batches tab.
  5. If any errors are present, they will also appear in the Status column.

Batches

The Batches tab allows you to see the history of the data transmitted to your billing system.

  1. From the Reports tab click Billing > Batches.
  2. You can use the filters to refine which results you see.
    1. Batch Created Start Date: Select Batch Created Start Date by clicking on the field and using the calendar or by typing in the start date with the MM/DD/YYYY format.
    2. Batch Created End Date: If needed, select Batch Created End Date by clicking on the field and using the calendar or by typing in the end date with the MM/DD/YYYY format.
    3. Patients: Type the first three letters of a patient's first or last name and select them from the drop-down.
    4. Payor: Type the first three letters of the payor's name and select the correct option from the drop-down.
    5. Billing Providers: Type the first three letters of the billing provider's name and select the correct option from the drop-down.
    6. Status: Filter results by status (Completed, Error, Pending)
    7. Claim ID/Treatment ID: Enter a claim or treatment ID to search for a specific item.
    8. Batch ID: Enter a batch ID to search for a specific item.
    9. Created By: Search for batches created by a specific user by typing the first three letters of the user's first or last name and select them from the drop-down.
  3. Once you have selected your desired filters, click Search.
    1. The Batches section will display all batches that meet the chosen search criteria.
    2. The Billed Items section will show all items included in all the displayed batches. You can click on the patient's name to navigate to their chart and on the status to open the batch to which the item belongs.
  4. To view the details of a batch, click View.
  5. The item details will open in a new tab.
  6. Billable items in each batch will appear at the bottom of the details.
    • If the batch file was sent via HL7 to Avea or CMD (or if it was sent using the HL7 Billing Type), review it by searching for the ID in the Batch ID field.

    • Then click Download HL7. Afterwards, locate the Downloads section of your computer to extract the files and view the data. This data can be viewed using Notepad or any similar txt viewer.

  • You can click on the red x anywhere it appears to delete the batch.

Do Not Bill

The Do Not Bill tab shows all items that have been marked as Do Not Bill.

  1. From the Reports tab, click Billing > Do Not Bill.
  2. Use the filters to search for specific items.
    1. Start Date: Select a start date by clicking on the field and using the calendar or by typing in the start date with the MM/DD/YYYY format.
    2. End Date: Select an end date, if needed, by clicking on the field and using the calendar or by typing in the end date with the MM/DD/YYYY format.
    3. Patients: Type the first three letters of a patient's first or last name in and select them from the drop-down.
    4. Payor: Type the first three letters of the payor's name and select the correct option from the drop-down.
    5. Billing Providers: Type the first three letters of the billing provider's name and select the correct option from the drop-down.
    6. Do Not Bill Reason: Click on the drop-down and select the desired reason. The search will return only the items with the matching Do Not Bill reason.
  3. Once you have selected your desired filters, click Search.
  4. The results displayed will match your selected filters.
    1. Buttons: The Select All/Deselect All buttons will allow you to select and deselect all results. The Expand All/Collapse All buttons display and hide the detail views of each item, Reset Filter removes the selected filters, and Excel and CSV export results to Excel or CSV files.
    2. Use the Filter fields to type in a patient name, date of service, location name, insurance name, level of care type, code, unit, claim format, billing provider name, claim ID/treatment ID, or reason.
    3. Click on the edit button to open the Do Not Bill Reason window.
      1. Select the desired reason from the drop-down list and click Ok. The selected result will appear in the Do Not Bill Reason column. This option is enabled in the Do Not Bill section of Settings > Patients and instructions can be found here.
    4. Clicking on the + icon will expand the item.
    5. Click on the checkbox to select an item. You can click on the patient's name to be taken to their facesheet.
    6. Click on the text in the Status field to view the batch.
    7. Click the Remove Do Not Bill button at the bottom of the page to remove selected items.

Ledger

The Ledger tab allows you to view all transactions for your location or locations. 

  1. From the Reports tab click Billing > Ledger.
  2. The filter fields at the top of the page can be used to narrow down results.
    1. Current Census: Click on this field and choose one of the following from the drop-down.
      • Current Census: Shows ledger items for patients currently in the census. Because data is pulled from the current census, you cannot edit the From Date and To Date fields. This option is the default.
      • Census: Select Census and then add from and to dates to view ledger items for patients who were on the census during that timeframe.
      • Admission Date: Shows ledger items for patients who were admitted during the selected date range.
      • Discharge Date: Shows ledger items for patients who were discharged during the selected date range.
      • Transaction Date/Time: Shows ledger items for transactions that occurred during the selected date range.
      • Posted Date/Time: Shows ledger items for items that were posted during the selected date range.
    2. From Date: Click on the field and choose the desired date/time.
    3. To Date: Click on the field and choose the desired date/time.
    4. Aging: Click on the field and choose the age range of the ledger items you wish to view.
    5. Click on the Search button to view the results.
    6. You can remove any filters by clicking on the Clear All Filters text.
  3. Click on the + button beside Advanced Search to access more filters. 
  4. Click on the - button beside Advanced Search to collapse it, click on the Search button to search using the entered filters, and click on the Clear All Filters text to remove all filters.
    1. Patient: Type in the first three letters of the patient's first name or last name, then select the correct patient from the drop-down.
    2. Type: Select the desired payment type from the drop-down. 
    3. Account: Select the desired account type from the drop-down.
    4. Payment Type: Select the desired payment type from the drop-down.
    5. Posted By: Select a staff member from the drop-down to view all all ledger items posted by that user.
    6. >: Use the drop-down options in this field in conjunction with the Outstanding Balance field to view all items.
    7. Outstanding Balance: Enter the outstanding balance amount you wish to filter by. Use in conjunction with the > drop-down.
  5. Below the filter options are the Export to XLS and Export to CSV buttons which allow you to export the ledger to an XLS or CSV file. Additionally, you can click on the + icons next to Charges and Payments to view more detailed breakdowns.
    1. Clicking the - icons will collapse the details again.
  6. The ledger items appear as follows.
    1. Click on the up and down arrows in each column to sort that column by ascending or descending order.
    2. Click on the name of the patient to navigate to their chart.
    3. Click on the + to expand the item's details.

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