Description

Main screen where the claims of the center or office are managed. It also allows configuration of different screens. The user will be able to change the status, verify and apply payments, view balances and charges of the claims. 


Access


Through the Main Menu
  • On the main screen, press the Billing button. 
Through QuickLinks
  • On the main screen, click on the QuickLinks text located at the top of the screen and select the Billing option.
Through Patients
  • On the Patient Details screen, click on the Billing button located at the top of the screen and select the Go To Billing option. 
Through Appointments
  • On the Appointments screen, press the Billing button located at the top of the screen and select the Go To Billing option.


Sections


Buttons

  • Offices: Allows you to select the office or center.

  • Refresh: When pressed, it updates the screen. 

  • Settings: Easy access to the billing configuration screens. 

  • Configuration: Allows you to configure the credentials of the provider and billing service company of your choice. Also, everything related to the sending of invoices and eligibility verification is configured. 

  • Fee Schedule: Allows the configuration of the rates to be used by insurance companies and medical plans.

  • Procedure Cash Rates: Allows the classification and configuration of prices of procedures of the office or center.


  • Insurances: Allows you to configure and edit the insurance companies and their coverage. 

  • Referring Providers: Allows the configuration of the register of suppliers, which refer to the office or center.


  • Facilities: Allows the configuration of the information of the facilities. These facilities are mostly where the provider evaluate patients. 

  • Staff and Providers: Allows you to configure the provider, nurse or group information.


  • Clearinghouse ACK's: Displays the electronic claims submission history screen. (This will only be enabled if the office or facility has selected E Health Partners as their billing service provider). 

  • Vouchers: Section where you will find, the payments of the insurers. 

  • Patient Pay: Section where you will be able to work, with the patient's payments. 

  • Reconcile: Section where you will be able to see the payments, which remain to be reconciled. User can manage claims in disputes and add payments to insurers. 

  • Print: Section where you will find several billing reports: 

    • Aging Report: Claims period report.

    • Payments By Payer: Allows you to filter reports on insurance payments.

    • Payments By Procedures: Allows filtering the report of procedure payments.

    • Daily Report: Allows to filter the daily billing report.

    • Grid Print Preview: Allows to display the previous billing report.

    • Grid To Excel: Allows exporting the report to Excel format.

    • Super Bill: Allows to print Super Bill report of the selected claims.  

    • Super Bill Compact: Allows to print the compact Super Bill report of the selected claims. 

    • CMS  1450/1500: Allows to display the 1500 form of the selected claim.

  • Transmissions: Easy access to perform multiple functions: 

    • Transmit: Allows the transmission of selected claims.

    • Dispute: Allows to work, claims in dispute:

    • Edit First 10: Allows editing of the first 10 claims if there are more than that amount. 

    • View: Pressing allows you to return to the main billing screen. 

    • Send All: Allows the transmission of all claims. 

    • Check for Responses: Download the files from the billing service provider.  

    • Save As 837p.EDI: Allows to export and save the file to a folder on your computer. 

    • Transmission History: When selected, it will display the screen with the history of the transmissions made. 

    • Received Files History: When selected, it will display the screen with the history of the received files. 

    • Eligibility History: When selected, it will display the screen with the history of the eligibilities made.


  • Create: When pressed, the screen for creating claims will be displayed.

  • Edit: After selecting a claim, press to edit the claim. 

  • Previous: Allows to close the screen.


Tabs (Located on the left side of the screen)

  • Billing Summary: Section where the summary of the billing of the office or center is displayed.

  • Patient Panel: Section where the patient's relevant billing information will be displayed.
  • Payer Summary: Section where the medical plan's detailed claims time will be displayed.

  • Filtros: Section where the user selects, to filter the screen. 

  • Tabla: Place where the claims are displayed. They will be filtered by status. Double click on the claim to edit it.


Bottom bar of the screen: Informative section, where the following information will be displayed:
  • Disputing: Displays the number of disputed claims.
  • Secondary: Displays the number of claims sent to the secondary health plan.
  • Selected Balance Total:  Displays the total balance of the selected claims.
  • Record Limit: Allows the user to select the limit of claims to be displayed on the screen. 
  • Restore Layout: Allows you to return to the original screen layout.