Integrated Billing Basics

  • Updated

Let's review how the Kipu EMR generates billable items from Evaluations and Group Sessions. Remember, the template is just a vehicle to transmit the billable item from the EMR to the integrated billing solution. 

Billable Items for Levels of Care

There are two ways to bill out from Kipu EMR: Level of Care (per-diem) and Ancillary.

Level of Care (per-diem)

  • Levels of Care are typically billed at a per-diem rate. This means that while the patient usually has more than one service in a day, the services will be bundled and paid at a daily rate rather than by individual service.
  • The patient is assigned a specific level of care by adding a U/R Plan to the Concurrent Reviews section of the patient facesheet. 

These Levels of Care are either:

  • Inpatient (DTX/RTC): The system looks for billable services and includes Vital Signs as a billable service as in the system. If you received a Vital Sign and are in an Inpatient level of care, that is a billable service.
  • Attendance Based (IOP/PHP/sometimes OP): The system looks for billable services with hours as in most cases you have a required number of hours pre-determined to bill for the service either by Compliance or by Insurance.

Ancillary

  • Any additional treatment or activities that are not included in the per-diem rate would need to be billed separately as ancillary items. 
  • Ancillary items can also be billed for patients not receiving treatment for a specific level of care.

These services can be rendered to the Outpatient Level of Care, or any level of care when the service falls outside of the per-diem services.

  • Outpatient or Ancillary Services: The system searches for any services (forms/groups) with billing codes and marked Ancillary. The report will pull these services in turn as a la carte services not pertaining to the Per Diem level of care services.

Billing on the Date of Discharge

The Kipu EMR will not prevent you from billing on the date of discharge for any of these services on the date of discharge (or after) unless you have the Do Not Generate Billable Day on Discharge Date selected for the Inpatient Level of Care.

Note: You will receive a soft warning (Yellow Circle) stating service is on/after the Date of Discharge on the Billing Report for any service billed on or after the patient's discharge date. 

 

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