Billing by Program allows users to choose which RCM practice and rendering provider the billable items should be associated with based on the Program the patient is assigned to.
Create Programs
Ensure each Location has Programs configured. Please follow these instructions.
Enable Bill by Program
Let's review how to enable Bill by Program within each Location.
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Click on your initials and select Settings.
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Open the Billing tab and click Location Settings.
- To update a location's settings, click the Edit icon.
- Check Billing by Program and click OK.
- Repeat for additional locations as needed.
Konnector Setup
A Konnector in the EMR must be configured for each RCM Facility that needs to be integrated with the EMR. Click here for instructions. Note: If you need additional Konnectors created to support Bill by Program, please contact Support.
Let's review an example:
I need to integrate my 2 EMR locations Treatment Center and Outpatient Center with my 4 RCM facilities. I also want to manage my billing based on patient program. Treatment Center offers the following programs: PHP, Detox, and Residential, while Outpatient Centers offers Telehealth and IOP.
I want to bill Residential, Telehealth, and IOP separately and the PHP and Detox programs together to match how I want to bill these programs in RCM. In this case, I will need 4 Konnectors for my 4 RCM facilities.
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Tips for Using Bill by Program
Bill by Program allows you to bill patients in one EMR Location to different CMD Facilities or RCM Practices (depending on which billing integration you use). This allows you to submit claims from the same EMR Location with different billing addresses, Tax ID, NPIs, or separate credentials.
Let's review some best practices for using Bill by Program:
- The patient must always be assigned a program.
- When two programs are assigned with the same start date, the system will use the most recently assigned program for the billable items.
- The system will use the Konnector that matches the Location/Program assigned to the patient on billable items's the Date of Service.
- When making retroactive changes to the patient chart (like changing the building/bed assignment), please wait 5 minutes before making another update to the same object.
- RCM Only: When using billing by program, you must add the new UR plan and ensure the service date matches the program assignment date for per-diem services.
If you are making retroactive changes to a patient whose documented services have already been generated on the billing report with the incorrect information, please contact support for assistance in updating the services to use the corrected data.
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