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Our Outpatient Billing uses an integrated Patient database provide for invoicing
Patient and/or Residents receiving services from an outpatient program.
Coordination of Benefits
When multiple health plans or insurance policies cover the same benefits,
Nursing Home Billing determines the plan or insurance policy to be invoiced first,
based on billing rules defined in the paysource tables.
Preview Bills and Invoice Corrections
After generating the bills, the results can be reviewed and the billing
can be regenerated with any errors corrected. Generated
bills are not accepted by the system until they are posted to the history
file, which provides the opportunity to make sure that the billing
is correct before committing to the Accounts Receivable.
Prior Approvals
Track requests for prior approval numbers from HMO Insurance plans that
generally require Prior Approval before they will pay for a patient's stay or
services. Once the Approval is received the home can invoice for the services
provided. Prior Approval information can be included on the invoices or the
electronic submissions.
The system tracks and allows you to follow up on new applications or those
pending Prior Approvals.
Treatment Authorizations (TAR)
Some states require that the long term care facility apply for a Treatment
Authorization before certain services and drugs can be invoiced. A complete
TAR tracking module is available to TAR and process the TARs |
