Generating Billables Items for Lab Requisitions

You can set up Kipu EMR to automatically generate a billable item for each processed Point-of-Care (POC) lab requisition. To use this functionality, the client must be integrated with a Kipu-supported POC lab interface and have access to the billing report.

Important: Automated lab billables only generate for POC lab requisitions created through a POC lab interface (POC testing refers to testing performed at a bedside, in a clinic, or in some location other than a lab). Non-POC labs (such as LabCorp or Drugscan) do not generate automated billables and must be billed manually via forms, templates, or other internal workflows. 

Setting up the Service

Before you can bill for lab items, you must ensure that the related code that you want to bill is present in the Kipu EMR and that you have set up a related service. You must be a Super Admin to complete these steps.

Code

Set up the CCode, HCode, and/or RCode that you would like to use to bill the Lab services. Click here for instructions. You will need this code when you create the service in the next section. 

Service

1. To begin, click on your initials and then click Settings. 
   
2. Then click the Billing Audit Tool tab.

2. Next, open Services click the Add Item button.

3. Fill out the Add/Edit Service window using the following information: 

   

   1. In the Service Name field, enter the desired service name (e.g., "POC Laboratory Service").
   2. Click the Create button.
   3. Set the Start Date to the date you will begin billing for this service using the date picker.
   4. Leave the End Date field blank.
   5. For Service Classification, select POC Laboratory. 
      • Note: That this option will only be available when a POC interface is active.
   6. In the Claim Format field, choose Professional or Institutional. This choice impacts the codes you should select, e.g., CCodes for professional claims and HCodes/RCodes for institutional claims.
   7. Set a default billing provider and Konnector for this service, as needed.
   8. Ensure the locations where you want to bill for this service are checked.
   9. Click the Submit button.

Adding the Service Authorization to the Patient Chart

Service authorization is optional for services with only one code, but it is recommended when multiple codes are configured in the Service settings. Follow these instructions to add a service authorization.

1. Locate the patient chart.
2. From the Information tab, scroll to the Utilization Reviews section.
3. Click Add Service Review.

4. Complete the information in the Services Authorization window. 

   

   1. The authorization date is the date you entered the authorization. 
   2. Select the service you set up to bill for labs. 
   3. Enter the start date and end date for the authorization. 
   4. Enter the authorization number. This number will be added to the billable item on the billing report for each requisition completed during the authorization's date range. 
5. Click Save Authorization. 

Lab Requisition

Next, enter a POC lab requisition for the patient. Click here for instructions. 

Important: The type of lab requisition must be set to POC for this functionality to work. Remember that the POC option is only available with a POC lab interface is active.

Generating the Billing Report

Navigate to the Billing Report. Each lab requisition will generate a billable item with the associated authorization number during the date range of the service authorization, if one exists. 

The following information is present on the billing report: 

• Patient’s data: Name, MR#, DOB, and insurance information.
• DOS (Date of Service).
• Service Authorization data: Service authorization #, Insurances, start and end dates for the authorization.
• Specimen ID: Displays the specimen ID from the lab requisition. (Shown as a blue hyperlink).
• Specimen Source: The source of the specimen as indicated in the lab requisition.
• Collected Date/Time: The date and time the specimen was collected. 
• Lab Name: The name of the lab
• Number of Tests Ordered: Displays the total count of tests ordered in that requisition.
• Info icon: Hovering over this icon displays a list of the names of each test (in the same order they appear on the lab requisition).

If a Billable Item Doesn't Appear

If a billable item does not appear on the billing report, confirm the following:

• The lab requisition was created as a POC
• The requisition is marked as Sent
• The POC laboratory service is active
• A service setting exists
• Any required POC questions were completed

If the issue persists, please contact Support.