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Insight Billing

Insight Billing. Margy Foody| Solution Architect. Batch Payments. Batch Payments. An easy way to post payments. Batch Payments. Allows easier posting of remittances Select Charges To Be Paid to show a list of patients with outstanding balances that have been billed to that payor

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Insight Billing

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  1. Insight Billing Margy Foody| Solution Architect

  2. Batch Payments

  3. Batch Payments An easy way to post payments

  4. Batch Payments • Allows easier posting of remittances • Select Charges To Be Paid to show a list of patients with outstanding balances that have been billed to that payor • Change the adjust codes to match the transaction needed

  5. Posting Debit Transactions in a Batch • Chargebacks, debits and other adjustments • When posting debit transactions note that the DO_NOT_NEGATE option in the Table Adjust must not be set to Y • Enter a negative amount on the Batch Pay screen to debit the patient account

  6. Batch Payment - Batch

  7. Batch Payments – Patient Ledger

  8. Secondary Billing Getting the payment codes on the next billing round

  9. Posting the payments • If the payments aren’t posted by the AR835 • Post on the Patient Ledger screen • Post via Batch Payments

  10. Posting Payments • Batch Payments • Adjudication Codes need to be posted on the CLAIM screen • Payments on the PAY/ADJ screen: • Adjudication codes must be updated from the CLAIM screen • Adjudication codes entered on the Pay/Adj screen must still be entered in the CLAIM screen

  11. Transfer the payment to the new payor

  12. Update the Original Claim

  13. Update the Original Claim These reasons are from the PAY/ADJ screen and are not reported in secondary billing

  14. Update the Original Claim

  15. Updating the Original Claim • On the REASONS tab – • Enter one or more reasons reported for the claim • Charge Number – Select the charge to apply the reason. This will create the CAS segment at the detail level • Enter the Reason Code and Group codes • Enter the adjudicated amount for this claim (the difference between the amount billed and amount paid)

  16. Updating the Original Claim

  17. Updating the Original Claim • To create the AMT segment in loop 2320 • Enter for the first procedure only • Leave the Charge Number field blank • This can be set to be the default action in the OPTBIL table – DONT_DEFAULT_CHARGE field

  18. Updating the Original Claim • Enter the Qualifier Code • Typically set to D – Payor Paid Amount • Enter the total payment received for the claim • This will be the sum of the SVD-02 segments • Because only one AMT segment is created, the amount is typically entered on the first procedure • If you decide to post the amounts for each procedure, these amounts are summed into one AMT*D segment

  19. Billing the Transferred Charges • To report the secondary billing • Update the report parameter: SUPPORT 2nd BILLING to Y • Run the billing batches as usual

  20. Billing the Secondary Charges

  21. Billing the Secondary Charge • CLM*9149.1*35***11>B>1*Y*A*Y************10   • REF*EA*9149   • HI*BK>V254*BF>V72   • ------------------------------------------------- • SBR*P*18*******MC   • AMT*D*10   • OI***Y   • -------------------------------------------------------- • LX*1   • SV1*HC>99213*35*UN*1***1   • DTP*472*D8*20140601   • REF*6R*1989-RGen   • SVD*12345678*10*HC>99213**1   • CAS*OA*B10*25  

  22. Other Questions • Questions?

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