Billing Audit Tool: Instance Defaults

Super admins can set and update certain default billing audit tool settings for their instances in the Instance Defaults tab.

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

3. Next, open Instance Defaults.
4. In the Instance Defaults tab, you will find the following settings.
1. Include Full Insurance Data: Use the toggle to include or exclude full insurance data in the Visits Authorized and Visits Used fields during transmission.
2. Interface Type: Choose Kipu RCM, Collaborate MD, HL7 Download, or HL7 SFTP Upload from the drop-down.
3. Autopopulate LOC Billing Provider: Set Konnector Billing Provider, Authorization, Same Signer, or Care Team using the drop-down.
4. Display Ancillary Billing Provider: This setting determines how the Billing Provider drop-down appears on Group Sessions and Evaluations marked as billable and ancillary.  
   • Hide: The Rendering Provider drop-down is not displayed.  
   • Edit Mode: The Rendering Provider drop-down will appear when editing the group session and evaluation.  
   • Edit and View Modes: The Rendering Provider drop-down will appear when editing and viewing the group session and evaluation.  
5. Autopopulate Ancillary Billing Provider: This setting determines which user is chosen as the billing provider for group sessions and evaluations marked as billable and ancillary.  
   • Do Not Autopopulate: No provider will be automatically configured as the billing provider. Users can still choose a provider from the drop-down (if configured to be visible).
   • Form Creator: The user who adds the Evaluation or opens the group session will be the billing provider.
   • Initial Signer: The first user who signs the evaluation or group session will be the billing provider.  
   • Last Signer: The final user who signs the evaluation or group session will be the billing provider.
   • Care Team: If a care team is assigned to the patient, the system will perform the following logic check to determine the billing provider.
     1. If the primary physician has the Rendering Provider feature enabled, the system will use this individual as the billing provider.  
     2. If the primary physician does not have the feature enabled, the system will look at the primary therapist. If the primary therapist has the Rendering Provider feature enabled, the system will use this individual as the billing provider.  
     3. If neither user is a billing provider, no value will be auto-populated in the field.  
6. Autopopulate Clinical Provider and Autopopulate Secondary Clinical Provider: Choose whether or not to autopopulate at all, or to autopopulate the form creator, initial signer, last signer, or care team. Determines which user is chosen as the clinical billing provider(s) and secondary clinical provider for group sessions and evaluations marked as billable and ancillary.
   • Arizona Clients Only: This setting allows you to control which billing provider appears on Box 19 and should only be configured for clinics with state requirements to send this information on the claim. Today, this behavior is limited to Arizona.
   • Do Not Autopopulate: No provider will be automatically configured as the billing provider. Users can still choose a provider from the drop-down (if configured to be visible).  
   • Billing Provider: This will automatically choose the user set as the billing provider as the clinical billing provider.  
   • Form Creator: The user who adds the evaluation or opens the group session will be the clinical billing provider.
   • Initial Signer: The first user who signs the evaluation or group session will be the clinical billing provider.  
   • Last Signer: The final user who signs the evaluation or group session will be the clinical billing provider.  
   • Care Team: If a care team is assigned to the patient, the system will perform the following logic check to determine the clinical billing provider.
     1. If the primary physician has the Rendering Provider feature enabled, the system will use this individual as the clinical billing provider.  
     2. If the primary physician does not have the feature enabled, the system will look at the primary therapist. If the primary therapist has the Rendering Provider feature enabled, the system will use this individual as the clinical billing provider.  
     3. If neither user is a billing provider, no value will be auto-populated in the field.  
7. Show Billing Codes In View Mode: Enable this setting to show billing codes in the view mode.
8. Enable Group Billing: Enable this setting to allow group billing.
9. Show Billing By Program in Konnectors: Show or hide the Billing By Program field in Konnectors.
10. Show Billing By Building in Konnectors: Show or hide the Billing By Building field in Konnectors.
11. Display Place of Service: Choose whether to hide the place of service, show it only in edit mode, or to show it in both edit and view modes.