Create Charges

This article covers creating charges to send to Avea. There are two ways to generate charges: Group Sessions and Evaluations.

The codes transmitted to the Billing report from the Group Session or Evaluation depend on how each template was configured initially and the patient's UR Level of Care for Insurance Billing and Clinical Level of Care for non-insurance/private pay billing.

Click here to learn more about configuring Group Sessions and Evaluations for billing. 

Group Sessions

Let’s review how to document and bill for a group session using the Level of Care codes (e.g., group sessions simply marked as billable).  

1. Navigate to Schedules. The Scheduled Group Sessions tab will be selected by default.
2. Click on the group session you’d like to complete.
   
   • Don’t see the group session you’re looking for? Navigate to Templates > Group Sessions and confirm that the group session has been made available for the day and location.  
3. Within the Group Session, you may see a rendering provider drop-down appear for selection (if the Group Session has been configured to use Rendering Provider. It’s important to select the correct Rendering Provider (if available) as this information will appear on the claim. 
4. Select Group Session Topics and complete any documentation for the Individual Assessment/Intervention section for the patient.  
5. Once the group session and related documentation are complete, click Group Leader Sign Off & Submit. Sign and click Submit.
6. The session appears with a complete status.
7. A charge will appear on the Billing Report for each of the patients in the session for review and submission to AveaOffice.
8. For Group Sessions only marked as billable, the code that appears on the billing report (H0015, 0905 in the example above) is determined by the patient's Level of Care. The system will use UR Level of Care for insurance patients and Clinical Level of Care for non-insurance/private pay patients.
   • The UR Level of Care is assigned to the patient chart when adding a Utilization Plan.
   • The Clinical Level of Care is assigned to the patient chart through an Evaluation form.
9. The codes configured in the Level of Care are Location-specific and are set up within Settings > Patients. You can review the codes associated with the LOC at any time.

Group Sessions - Ancillary

When completing group sessions that have been marked as ancillary during setup and that have more than one code added, you’ll need to select the correct code to bill for the session from the drop-down. This is the code that will appear on the Billing Report to send to Avea. 

You can also adjust the Place of Service for this group session using the drop-down, if present. This field may be hidden by template settings.

Evaluations

Let’s review how to document a billable evaluation from the patient’s chart using the Level of Care codes (e.g., evaluations simply marked as billable).

1. Navigate to the patient’s chart and select the tab containing the evaluation form. Click Add Form.
2. A pop-up appears with all the forms available within that tab. Click Add.
3. Click the Edit icon to complete the form.
4. Complete the form.
5. Some forms may have a Rendering Provider drop-down. It’s important to select the correct Rendering Provider (if available) as this information will appear on the claim.
6. When done click Sign & Submit. Sign and click Submit.
7. Once all required signatures are collected, the related charge will be available on the Billing Report for review and submission to AveaOffice. 
8. For Evaluations only marked as billable, the code that appears on the billing report (H0015, 0905 in the example above) is determined by the patient's Level of Care. The system will use UR Level of Care for insurance patients and Clinical Level of Care for non-insurance/private pay patients.
   • The UR Level of Care is assigned to the patient chart when adding a Utilization Plan.
   • The Clinical Level of Care is assigned to the patient chart through an Evaluation form.
9. The codes configured in the Level of Care are Location-specific and are set up within Settings > Patients. You can review the codes associated with the LOC at any time.

Evaluations - Ancillary

When completing an evaluation marked as ancillary during setup with more than one code added, you’ll need to select the correct code from the drop-down to bill for the Evaluation. This is the code that will appear on the Billing Report to send to Avea. 

You can also adjust the Place of Service using the available drop-down, if present. This field may be hidden by template settings.

Send Charges to Avea

Once charges have been created, they appear on the Billing Report for review and submission to Avea. Click here to learn more.