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List of Common Billing Questions

List of Common Billing Questions

List of Common Billing Questions

  • How to enter Prior Auth Code to the claim?
    Go to the claim->Insurance and Payments tab->Update Insurance->Additional Information tab->Type in
    Prior Auth no.
     
  • How to enter NDC Code, Units and UOM to the claim?
    Go to the claim->update CPT ->Click on Additional Info and type in NDC Code, Units and UOM.
     
  • Claim error asking for ‘admission date’
    Go to Claim->click on Claim data tab->type in the hospitalization date.
     
  • Where do you type additional notes for claims?
    Go to Claim->click on Claim Header tab->type in the note in the box ‘claim note’ for electronic claims,
    and type the notes under HCFA 19 for Paper claims.
     
  • If the claim has multiple CPT Codes, how do you send only certain CPT, not all?
    Uncheck the box next to the CPT codes that you do not want to send.
     
  • CLIA ID missing on the claim
    Go to the claim->update CPT ->Click on Additional Info and type in CLIA ID.
     
  • If the patient (child) had Dad listed as guarantor/responsible party because he is the insured,
    but they want to send statements to Mom’s address, how can this be accomplished?

    Go to Patient Demographics, under Responsible Party choose Guarantor and add Mother’s
    information. Then go to Insurance info, and under Subscriber field, add Father’s name as the
    guarantor.
     
  • How to get a list of patients that are in Collection status regardless of the collection cycle they
    are in?

    Go to Accounts Lookup->select ‘given to collections’ under collection status->select the date range->
    click Lookup. This will list patients who are in Collection status.
     
  • How to delete the out of office encounter?
    Go to practice band>out of office>choose the date range>pull the encounter>highlight the encounter>
    hit delete on the bottom. Note: Out of office encounters can only be deleted if a claim has not been
    created.
     
  • How to create the hospital or out of office encounter?
    Go to practice band>out of office encounter>new>choose the patient>enter all the required fields>View
    claim to create the claim.
     
  • How to set the billing recall for payment plan?
    From accounts look up or collections -> Select patient -> and click alert>set the billing alert for payment
    plan.
     
  • How to pull a list of patients on a payment plan?
    From the Billing band in the left navigation pane, click the Billing Alert Recall icon>From the Look Up By
    drop-down list, click the Protocol option>Click the Sel button next to the Protocol field>The Protocol List
    window opens.>Check the Payment Plan box>Click the OK button>The Payment Plan alert name displays
    in the Name field on the Billing Alert Recall window>Select a date range from the Date(s) From and To
    drop-down calendars>Click the Lookup button>The window displays list of patients who have Payment
    Plan alerts for the selected date range> To view the alerts and notes that have been set for a patient,
    check the box next to the patient's name and click Alerts.
     
  • How do we post a NSF?
    Do an account inquiry to check the date of original payment.
    Go to payments, add patient payment.
    Post a negative payment using same check number, and the date received back from bank.
    Click on get claim on bottom. Have the > = 0 on or have this blank.
    Click on the original claim and post a negative amount under paid, click on post cpt
    Post the negative amount under the paid field on the cpt line, click ok, say yes to saving changes, ok.
    Now this balance is back on the patients accounts.
    At this point you need to go to claims and create a claim to charge the patient for the NSF fee the bank
    charges the Dr. This is done by clicking on claim, create new claim. Again you are using the date you
    received the check back from the bank for the claim date. If there is a copay on the patients claim when
    you create it, highlight it and delete it. Put in you NSF code, icd9 code is not required, click on
    insurance/payments tab, click on bill to patient, change claim status to Patient.
    Now the patient’s account should show the bad check fee and the negative posting.
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