Changed payer name to “the BHPN”, this will up date through the receivables, etc. CR is also updating the words on the export, the export file, the ‘identifier’ words etc. The background semantics that users cannot do themselves. IF an ORG has a Fee Schedule, service code descriptions, etc., ORGs will want to update as needed.
Recent update to include the removal of the 59 modifier based on a letter from Easter Seals that it was no longer needed, since their system can now evaluate this criteria. Additionally, if you use modifiers, they will provide the Direct/Indirect ‘word’ in column Z, and the POS code, will provide an independent setting for the vendor information, the “_O_”, “_H_”, POS 12: Home will be “H”, all others/blank will be “O”.
To summarize, IF you use modifiers, DI/IN will provide the word, Direct/Indirect in column Z respectively. Vendor Name/Number Direct (_H_) works off of POS: 12 – Home, to provide that info, all other POS codes/missing, will use (_O_).
IF you use POS only, it will work as initially programmed, POS: 11 – Office, word Indirect and _O_, all others or blank will receive Direct and _H_.
Brief overview: Before explaining the download, please understand what CentralReach is trying to do for our clients. There is not a place in a claim form to identify Indirect or Direct time. We have created a way to do this for our clients in order to simplify obtaining the data the BHPN wants in their spreadsheet. To do so, we are using the POS codes or modifiers, see notes from 7/5/17 above, from the billing entries to identify Indirect or Direct time. Please don’t forget to update authorizations if you choose to make 2 separate codes, 1 with the IN modifier and 1 with the DI modifier, as needed.
Now that the download is explained, let’s do some billing!
The first step is to set the 4 id’s for the billing entries in the system ORG account for your facility. The Vendor ID and Vendor Name should have been provided to you by the BHPN. If you do not have those please contact the BHPN. Please enter exactly as the BHPN provided to you. Navigate to your account information and then claims settings. Note: This information is pulled directly from each timesheet, while 99% of all organizations use their main account for the billing settings, if your ORG uses a different contact ID to populate the billing information for timesheets/claims, then add the Vendor ID’s to that Contact. If you set it up and it does not populate as expected please contact support and we will troubleshoot with you.
Now input the 4 different fields using the dropdown to select each field.
Next to add the BHPN unique identifiers for Employees or Client, you will do the same thing, navigate to the contact, goto claim settings, and add the info.
Once setup, move to the billing screen and format this screen as if you were going to print your invoices/make claims, i.e. set up the screen to only contain the BHPN billing data. The billing entries can now be exported in a format that can simply be uploaded to the BHPN without having to manually change the data in the excel spreadsheet. To export the billing module to the BHPN format, simply click on the “Export” (little cloud) button on the top right hand corner. Note: add the filter for ‘Active only’ on the Billing screen, this way the download will come out with the same total as CentralReach (and will not export deleted or voided items).
After that, when given the selection choices for the export format, simply select the BHPN export in either csv (comma separated values) or txt (a simple text file). After that, you should be able to copy an paste that data to the spreadsheet that the BHPN provided to you without any issues.
You will have to move to resources to get the file. Click to download the file.
Double check the data columns here. Visually inspect to make sure your data is complete. If info is missing you can add it manually, or return to CentralReach and update the info to make sure the missing data comes out with the file.
Once you are satisfied the data is ready. Copy from cell A2 to the end of how your input sheet is formatted.
Now paste that directly into the BHPN Input sheet.
Finish up the rest of the workbook and submit via your regular channels.
Troubleshooting the download:
Where does the data come from: MRN comes from the payor screen at the Subscriber level; DOB comes from the client contact, in the basics. Note: for the BHPN it’s a good idea to set them up having the Subscriber and Patient with identical information.
Authorization data, dates, procedure codes, service dates, DX code, etc., all come from the timesheet level data.
What if my total does not match? Remember that on the BHPN Input spreadsheet there are no hours – just codes, units, and one definition of rates (on the rates sheet that you have to define). In CentralReach are all of your rates correct on every appointment, and in your settings, is the time on your appointments rounded to quarter hours, etc. If not, that’s where we would start the troubleshooting and you can too.
Updated 112217 AS