Day-to-Day Billing Flow (Best Practice - Recommendation)
Daily Tasks
⃣. Review Encounters for modifiers, physicians, insurance, auth, daily notes for work comp.
⃣. Approve Encounter (you can use the internal approve or the batch in the screen shot)
- Option 1: Chance status to approve inside encounter and Click Apply Changes
- Option 2: Click Approve and Next inside the encounter
- Option 3: Batch Approval on Main screen (Best option)
⃣. Submit Electronic claims/Print out 1500s
⃣. Stuff Envelops with 1500 & Notes to be mailed / stamp/ Fax 1500s
⃣. Post payment (either from mail day before or HENO payments)
- How to Apply Insurance Payments
- Applying Patient Payments (You can access the patient payment from inside the insurance payment)
⃣. Post any payments from mail
⃣. Check EDI report, fix any problems/ Claims Denial/Reject Report
- EDI Status Review
- Review denial/rejection report
⃣. Update patients cases if no more copays, co-ins, etc.
⃣. Make internal notes for any changes to patients cases
⃣. Resolve any issues with insurance payments (sending out appeals or rebilling paper claims)
⃣. Make refunds for patients we owe (once all claims have been paid)
- Option 1: Billing tab -> Reports -> Unapplied -> Patient
- Option 2: Billing tab -> Reports -> Potential Refunds (Best option)
Bi-Weekly Tasks
⃣. Review AR Twice a Month
- Billing tab -> Reports -> AR -> Insurance
Monthly Tasks
⃣. Work No Response
- General tab -> No Response Bubble
- Billing tab -> Reports -> No Response
⃣. Statements
- Closing Cancel and No show orders for statements
- How to Make/Generate Statements - will be updating article soon