Frequently Asked Questions: Billing
Many of the adjustments to a financial visit/record can be done from within the individual visit “Visit Details.” A common pathway to a visit record is Home > Patient > Financial tab. Scroll down to the bottom of the Financial screen and select the hyperlink for the individual visit that needs to be adjusted. This pathway will be used in the following FAQs unless otherwise stated.
Q:How do I reverse a payment posted on a visit?
Identify which code is linked to the misapplied payment. Select that code within the Ledger display there is a small icon on the right-hand side (hover and it will show Adjust Ledger). The only option on the next screen will be “Adjust Ledger,” as partial amounts cannot be adjusted at this time. The entire amount will be reversed, and the user can reapply the appropriate monies to the appropriate visit.
Q:How do I modify the information (CPT/ICD/Charge) on an Encounter?
Before the Encounter status has been changed to “Ready to Bill,” any changes can be made within the Encounter screen from the patient’s chart.
After the Encounter status has been changed to “Ready to Bill,” but not yet submitted to the payor, changes will be made from the Visit Details within the Financial tab.
After the Encounter status has been changed to “Ready to Bill,” and submitted to the payor, changes will need to be considered a corrected claim.
Q:How do I view the payments, write-offs, and/or adjustments that have been posted to an individual line of a visit?
From the Visit Detail, select the hyperlink for each procedure code.
Q:How do I change the amount for a CPT?
If the encounter has not been billed, the amount can be changed in the Fee box within the encounter
If the encounter has been billed, the amount can be changed in the Visit Details of the specific CPT under Plan Fee Amount.
Q:How do I send a corrected claim?
From the individual Visit Detail, select “Resubmit.” Select the Extra Info tab and update the field “Claim Frequency” status to “corrected.”
Q:How do I make a payment to the account vs. a single visit?
A payment can be applied to an account applying the monies to the oldest balance first from the Financial tab of the Patient’s Chart. The “Payment” option is at the top, right-hand corner of the screen.
When a payment needs to be applied to an individual visit, use the “Payment” option at the bottom of the Financial screen after the appropriate visit line has been highlighted.
Q:How do I know a claim has been submitted?
The Visit Detail screen will display “Yes” or “no” under “Submitted”
Q:How do I know if there is an electronic EOB?
Choosing the Elect EOB tab from within the Visit Detail will display all available EOBs for the selected visit.
Q:How do I send a paper claim for an electronic payer?
From the Visit Detail, update the status of “Force Paper” (middle of screen) to Yes. To manually print the previously submitted claim, select “View Submit” and when the system displays the claim form, select print. A color printer is recommended for the claim to print in CMS1500 format.
Q:How do I change an insurance payer on a visit?
Before the Encounter has been marked “Ready to Bill,” the insurance can be updated within the Visit Details from the Encounter screen.
Once the status is “Billed,” but has not yet been submitted to the payor, the appropriate plan can be updated within the Visit Details.
Once the status is “Billed,” and it has been submitted, changes would be made by choosing Resubmit and update the plan within the Visit Details.