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Our Medicare Part B Billing module features an integrated database to handle all
the acceptable methods of billing for Medicare Part B eligible services and supplies.
Advanced features simplify the tasks and is fully integrated with Accounts Receivable.
Census Driven
Complete the Daily Census process and the system maintains a record of resident
Room changes, admissions, discharges, transfers and changes. This data is
combined with their paysource coverage to generate Room and Board charges
to be invoiced to the proper paysources. A complete history of all changes
is maintained for audit and statistics
Coordination of Benefits (COB)
When multiple health plans or insurance policies cover the same benefits,
the Billing will determine, using the defined rules in the paysource tables,
the order in which the plan or insurance policy is to be invoiced.
Preview Bills & Corrections
After generating the bills, view the results for potential errors, if errors are
found, you can correct them and regenerate the billing. Billing can be rerun
until the bills are posted to the history file. This provides
you with the opportunity to correct any mistakes before committing to the results
to the Accounts Receivable.
Track 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
provide. Prior Approval information can be included on the invoices or the
electronic submissions.
Track Treatment Authorizations (TAR)
Certain states require Treatment Authorizations (TARs) before you can bill for
specific services and medications. The TAR module enables you to submit the
requests for authorization numbers and track those issued.
The Billing program accesses the TAR data as required. The Program issues
alerts for expiring TARs so the Authorizations do not accidentally lapse and
the invoices will not be accepted.
CMS-1500 Forms
Print Laser-generated, forms for billing or reference. Billing is normally
submitted electronically, either directly to the Intermediary or through a
clearing house. But some organizations like to keep a copies of the original bills.
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