Billing Enhancements

We are excited to be releasing the much anticipated Billing Enhancements:

Contract Manager Version 1.0

Billing Rules Engine 1.0

Improved Billing Manager

 

Contract Manager 1.0:

Contract Repository:
  • Record and manage contracts with multiple payers, multiple locations

ERA Management:

  • Process ERAs manually or electronically
  • Keep a history of all ERA’s processed

Manage by Exception:

  • Flag items that were not paid according to your contracts
  • Tools to research why payments were affected
  • Collaborate with staff to fix issues so claims can be processed accurately

Checks and Balances

  • Integrated with Manual Payments module
  • Generate Accurate Patient Statements
  • Refer to your contracts to look up Allowed Amounts and balance patient accounts

 

Billing Rules Engine 1.0:

Simple, easy-to-use, billing rules module to create custom rules for easier claims generation. Automate your common services yet still create fee-sheets and claims on-demand just like before.

Create and manage rules:
  • Define rules to update fee-sheets with codes for a type of payer or for a specific payer, a facility/program or service location
  • Define rules based on documentation completed by staff
  • Apply rules based on dates of service
    • Rules are time-boxed, because we know they tend to change now and then
  • Fee-sheets provide visual cues on the origination of a code in the fee-sheet
Apply modifiers as needed:
  • Rules allow you to start with one code and end up with a code and modifier
  • Modifiers can applied based on place of service, age and/or provider’s education level

Improved Billing Manager:

  • Billing Manager now remembers your searches
  • Access fee-sheets without leaving the Billing Manager
  • Update diagnosis justification inline
  • Executive Dashboard for Billing
Manage by Exception:
  • Limit searches to closed encounters by default
    • Global setting must be enabled
    • Closed Encounters are encounters that have billing rules applied