Billing Audit Tool Settings Overview

The Billing Audit Tool is designed to minimize errors by automating coding, ensuring required documentation is present, aligning clinical workflows to the billing system, and simplifying pre-claims checks before submission. It also supports in-house and third-party billers. All the settings required for billing use in the EMR can be found here.

Required Permissions: Super Admins

To navigate to the Billing Audit Tool settings, complete the following steps. 

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

3. The following tabs elements are available for configuration.

   

Billing Audit Tools Settings

• Dictionaries: View and edit statuses for authorization, do not bill reasons, and place of service statuses.
• Codes: Configure CCodes, RCodes, and HCodes for your location.
• Services: Create services for ancillary services that require authorization.
• Provider Settings: Create and edit providers for outpatient services.
• Location Settings: Set up and manage billing settings for your location.
• Payer Rules: Create and edit billing and payer rules.
  • Create a payer rule

  • Create Billing Rules 

    Add Modifier Admit to Discharge Bundling Case Management (Beta) Do Not Bill Drop Diagnosis Codes MAT Dosing

    Office Based MAT Present on Admission Replace Replace Place of Service Service Review Unit Billing

• Warnings and Errors: View and edit billing warnings and errors to customize which issues block submission or flag an item for review.
  • Pre-transmission errors: Catch missing authorizations, diagnoses, claim formats, and billing provider data before a claim goes out
  • Post-transmission CMD errors
  • Post-transmission RCM errors
• Lab Settings: Create and edit mapping between billing codes and lab result panels.
• Instance Defaults: Create and edit billing settings for your instance.
• Ledger: Create and enable charge accounts, payment types, and statement templates for use in billing.