Billing Report: Send Charges (Integrated Billing)

  • Updated

You can send charges from the Kipu EMR to Avea, CMD, or through HL7 using the Billing Report (all locations or location-specific). The Billing Report is also available from the patient’s chart if you prefer to bill by patient.

Important: There is a delay between when the charge is created and when it appears on the Billing Report (typically around 5-15 minutes). 

Billing Report

Let's review how to bill from the Billing Report. The Billing report pulls all charges created in the Kipu EMR and allows you to select which charges you would like to send to for billing. 

  1. Navigate to the Reports tab and select Billing.

  2. At a minimum, enter the start and end date range and click Search.

    • Start Date: This is the date when the evaluation was started by the Provider (this may not be the date of service). To account for this timing, we recommend running this report once a month for the previous month to ensure all charges have been sent to the RCM. 
  3. All unbilled charges appear in a list view.
    1. Name: The name of their patient followed by their MR number. You can use the filter field under Name to search by patient name or by their MR number.
    2. Date: The date the evaluation or group session was started.
    3. Admit Date: The date the patient was admitted. 
    4. Discharge Date: This is the date the patient was discharged. Kipu will not stop you from billing services on the date of discharge, however, the system will give you a soft warning (yellow circle) stating the service is on the Date of Discharge. If you click on the checkbox below Discharge Date, you can choose to view discharged or non-discharged patients.
    5. Location: The location where the patient was treated.
    6. Insurance: The patient’s insurance company who will be billed for this service. 
    7. LOC: The patient’s level of care as established in their Utilization Plan or Clinical Level of Care. This field will be blank for ancillary charges.
    8. Codes: The code(s) being billed.
    9. Units: The number of units being billed.
    10. Claim Format: Institutional or Professional. 
    11. Billing Provider: If this field is blank, the default billing rendering provider set up in the Konnector will be billed on the claim. Otherwise, the name of the provider on the patient's UR plan (per-diem services) or selected within the Evaluation or Group Session (ancillary services) will appear here and will be billed as the rendering provider. Additionally, you can manually choose a different Billing Provider for the claim, if needed.
  4. Click on the Hx icon to view the Payer Rule History, including the name of the payer rule applied, link to the payer rule applied, and the original code(s), claim format, place of service, and units (if modified by the payer rule).
    • Note: This button only displays if the charge was modified by one of the following payer rules: Replace Code/Claim Format, Replace POS, Unit Billing, or Add Modifier.

  5. Click on the Edit icon to make minor updates to the charge lines like including or excluding Codes (ancillary charges with multiple codes available only), adding a Modifier, Billing Provider, or Place of Service. You can make these updates in bulk e.g., if you updated the diagnosis code order, you can apply these updates to all similar charges for the same patient in the batch. Additionally, you can set this as the default for all future charges of this type for the patient using the checkboxes in the Edit Claim window.

    • Note: You can update the claim format here, however, the default code set available (C Codes for Professional and H/R Codes for Institutional) won't change and will still display the code set for the original claim format. If you choose to transmit the charges with the updated claim format, you may need to change the codes in your billing software. 

  6. To remove diagnosis codes from the claim, click the x. To add excluded diagnosis codes, click the +. The changes made here will be reflected on the patient's chart under Billing > Diagnosis Codes.

  7. Click on the + to view additional information about this charge.

  8. You can see insurance plan information, diagnosis codes, level of care, and whether the charge was added through an Evaluation or Group Session. When billing per diam for Level of Care, charges on the same day will group together under the same charge line with their associated durations.

    • Both Evaluations and Group sessions are viewable by clicking on the hyperlinked title.

  9. The system has a few built-in alerts. Red alerts mean that you cannot bill that charge until the alert issue is resolved. Yellow alerts are a warning and will not prevent billing. Click here for common errors and resolutions.

  10. Use the Select checkboxes for items that you want to bill or use Select All to choose all charges that can be billed on that page (items with red alerts won’t be selected).mceclip3.png

  11. You can also use the Don’t Bill checkbox to move charges to the Do Not Bill tab on the Billing Report. You will be asked to include a Do Not Bill Reason if enabled. mceclip4.png

  12. Once you have made your selections, click Transmit at the bottom of the report.

  13. Following transmission, you will be directed to the Batches tab. Here will you see your batch listed as pending.

  14. Refresh the page to confirm the Transmitted column has been updated to Yes and click on the View button to review the charges. You must review every batch submitted. Just because the batch was successfully transmitted does not mean that all charges within the batch were successfully sent.

  15. Claims that were successfully transmitted will have a Claim ID.

  16. If there is an error message instead of the Claim ID, the charge was not sent to the integrated billing system. The best option here is to use the red X to delete the individual charge, fix the issue, and then re-bill. Click here for a list of transmission errors and how to resolve them.

  17. If there is an error without a delete button, you have a few options. With any of the options below, we recommend downloading the original batch details to an Excel or CSV file to create a worklist. Options include: 

    • Delete the entire batch, manually remove the claims that were successfully transmitted to the billing system to prevent duplicates, and rebill from the Billing Report. 

    • Delete the entire batch and manually mark the successfully transmitted claims as Do Not Bill in Kipu EMR with the Do Not Bill Reason of Already Billed. Then rebill the other charges.

    • Manually bill the errored charge(s) directly from your integrated billing solution.

Move From Do Not Bill to Bill

You can move an item previously marked Do Not Bill back to the Billing tab for transmission to your integrated billing system.

  1. From the Billing Report, click on the Do Not Bill tab.2.png

  2. Enter your date range and click Search. 

  3. Check the box and click Remove Do Not Bill to send the charge back to the Billing report.blobid6.png

Patient Chart

You can bill for an individual patient directly from their patient chart. 

  1. Click on the Billing tab in the patient chart. Because these tabs can be renamed, your tab may named something else like Patient Ledger, Billing Report, etc. blobid7.png

  2. This tab contains Billing Items, which mirrors the Billing Report but only shows charges for the specific patient.

  3. Bill out charges (or move charges to Do not Bill) from the Billable Items report. 

  4. When editing a charge, you can make these updates in bulk e.g., if you updated the diagnosis code order, you can apply these updates to all similar charges in the batch. Additionally, you can set this as the default for all future charges of this type for the patient using the checkboxes in the Edit Claim window.
    mceclip10.png

  5. Use the Select checkboxes or Select All button to choose which charges to bill. Anything with a red alert cannot be selected. Click here to learn more about resolving errors.mceclip11.png

  6. Select the Don’t Bill checkbox for anything you don’t want to send to your integrated billing solution. If you have configured Do Not Bill Reasons in your Patient Settings, select the appropriate reason.mceclip16.png

  7. Click Transmit to bill. You will be automatically directed to the Billed Items tab.

  8. You will be automatically directed to the Billed Items tab. Each transmitted charge appears on this tab as Pending.

  9. Refresh the page. You will see the status of the claim in the Claim ID field.

  10. Each billable item with a Claim ID has been successfully sent to your integrated billing system.

  11. Any items with an error message instead of an ID failed and will need to be deleted and rebilled. Click here for a list of transmission errors and how to resolve them.

  12. Click on the error message to open the batch.
  13. Use the Delete (x) button to send the charge back to the Billable tab.

  14. If there is an error without a delete button, you have a few options. With any of the options below, we recommend downloading the original batch details to an Excel or CSV file to create a worklist. Options include: 

    • Manually bill the errored charge(s) directly from the integrated billing system.

    • Delete the entire batch and manually mark the successfully transmitted claims as Do Not Bill in Kipu EMR with the Do Not Bill Reason of Already Billed. Then rebill the other charges.

    • Delete the entire batch, manually remove the claims that were successfully transmitted to the billing software (within the system) to prevent duplicates, and rebill from the Billing Report. 

  15. Do Not Bill Items: From this tab, you can review the list of charges marked as Do Not Bill and their reasons (if selected). You can move charges from this tab back to Billable items if needed by selecting the Charge and clicking Remove Do Not Bill.blobid8.png

  16. Diagnosis Codes: This tab allows you to set the default billing order for the patient’s diagnosis codes. This is the order that will appear on the claim, and if you need to modify the order to maximize claim payments, use the arrows. Do keep in mind, however, that you cannot remove a diagnosis code from claims here. If you do need to remove a code, you can remove it from the specific charge by editing the charge under Billable Items.blobid9.png

  17. Ledger: This tab allows you to manage patient payments.

Delete a Batch

Follow these steps below to delete a batch.

Charge Information Transmitted to the Billing System

  • When charges are sent to Avea, the billing report information is used to match the charges between the two systems. Check out the Kipu EMR + Avea Integration Tables article for more information. 
  • When charges are sent to CMD, the billing report information is used to match the charges between the two systems. Check out the Kipu EMR + CMD Integration Tables article for more information. 

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