Claim Creation and Daily Reconciliation

Articles

Viewing the Billing Status on the Schedule
The Billing Status will organize appointments into 5 groups: No Charges Exist, Superbill Exist, Complete, Cancelled, or No Show.
Posting Electronic Superbill Charges
Once the office is fully live and ready to utilize the EHR side of Office Practicum, the Clinical side of the system will begin to generate Superbill charges for documented sections.
Charge Posting Options
Version 14.19 Overview Regardless of where you choose to post electronic superbills ( Tracking , the Billing Center , or the  Patient Account ), the same posting options will be available to you. The sections below define the posting optio...
Manually Enter a Claim
Daily posting is done from the Tracking tab. Charges for patients without an appointment are posted from the Patient Account.
Manually Enter a Superbill
Version 14.19 Path: Smart Toolbar > Super button Path: Smart Toolbar > Account button > Charges tab > + Superbill button Overview The Superbill is an intermediate billing stage where you can enter charge information without imme...
Edit or Void Current Charges
Current charges (charges that have not yet been included on a daysheet) can be edited from the Tracking tab, the Patient Account, or the Claims + A/R tab in the Billing Center.
Enter Hospital Charges
The steps below will guide you on how to post charges for hospital visits.
Adding Other Items to Claims
As you are manually creating claims, you may find that you need to record other claim information that is not found in the Basic Information tab of the Add/Edit Charges window.
Verify All Appointments Have Charges Posted
The steps below help to ensure every patient on the schedule has charges posted if they were seen.
Reviewing Open Superbills
Version 14.19 Path: Billing tab > Billing Center button > Superbills tab Path: Main Navigation Panel > Superbills Overview The Superbills tab of the Billing Center houses all unconverted superbill charges for your practice. It is...
Review Current Claims
Current claims can be viewed on the Current Claims tab of the e-Billing Center. Current claims are defined as those that have yet to be archived by the processing of a daysheet.
Send Claims to the Transmit Queue
Claims are sent to the transmittal queue pending submission of electronic claim files and/or hcfa printing. Current claims are defined as those that have not been processed through a daysheet.
Batch Print CMS-1500 Forms
Any claims that are to be dropped to a CMS-1500 form should have that indicated on the Payer Setup table.
Reconcile Monies Received on a Daily Basis - Front Desk
Follow the steps below to balance all monies collected for a date of service. This process should be done prior to running the daysheet.
Close Out Daily Activity - Running a Daysheet
When you run, or process, a DaySheet, you convert current patient transactions - claims and payments - to archived patient transactions.
Posting Self Pay Charges and Patient Adjustments
If a patient is a true Self Pay patient, follow the instructions below to post their charges and apply adjustments if appropriate.
Applying Copayments While Posting Charges
Version 14.19 It is best practice to apply copayments that have been taken for services while posting your charges. Incorporating this into your workflow will decrease the amount of credits that need to be applied to balances prior to running sta...
Unposting Superbills
Version 14.19 Overview At times, it may be necessary to unpost a superbill that was converted in error. This can be done from the patient's account. Navigate to the patient's account. Click the Charges  tab. The posted superbill...
National Drug Code (NDC) Claims Filing Tips
Version 14.19 Version 14.19.6   |   Version 14.19.5 Version 14.19.6 Overview This article should serve as a guide to users regarding the use of NDC Numbers (NDCs) and Units of Measurement (UOM) when billing medications ...
Billing Vaccines to TRICARE
Overview Submitting information for TRICARE vaccines in order to get paid appropriately is a source of difficulty for many practices. No matter who does your billing, having a full understanding of how this works is important for all practices that...
CMS-1500 Details
Version 14.19 Overview This article explains the Fields in the CMS-1500 form. The Form is shown in the PDF below and the Field descriptions are in the following section. CMS-1500 Field Descriptions The following table details the Fields of...