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Our Healthcare Billing modules are specifically designed to comply
with the complex rules involved in generating private and third party bills
to healthcare intermediaries. The software can follow detailed rules to ensure
that the bills present the insurance companies and intermediaries with bills
in the proper data and formats.
Specialized functions enable the user to automatically void and rebill
to different insurance plans or to retroactively change the reimbursement
rates.
Complying with the complicated rules of is critical in being
able to collect the payments promptly.
Billing modules access the same data as the Registration and Census modules, eliminating redundant data entry. This
integration ensures that all residents are billed and all days of service accounted for.
The Billing process can generate the invoices for all paysources simultaneously,
eliminating the need to re-run the program for each type of invoice. All bills
can be reviewed and corrected before committing them to the history files.
Prior-Approvals
When Insurance companies require Prior-Approval numbers for submission of certain types
of invoices, the system can track the Approvals. You will always know the status of the
Prior Approvals.
Medicaid and Medicare Billing
Our Billing modules handle all State Medicaid billing requirements,
including rules for bed retention's and leaves of absence.
Census will
also provide alerts when a resident is exhausting LOA and Bed
Retention benefits. Our billing modules have been certified HIPAA-compliant
for the 837/4010/A
Medicare and Medicaid Standards.
Coordination of Benefits
Co-insurance and deductible amounts not covered by residents primary
insurers are automatically billed to appropriate third parties.
Error Checking and Validations
Extensive validations and verifications on the charges ensure that procedures
are valid for the client diagnoses and are billed properly.
Census and
Registration provide patient summaries
to ensure that all resident days are accounted and invoiced.
ADL Billing Modules comply with the latest requirements for
Consolidated PPS, and HIPAA Bill types.
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