Billing

The Billing Module is represented by a dollar icon, and is where users are able to manage employee time tracking, set up billing permissions and rates, submit claims, produce invoices and post payments.

Timesheets

Information about Timesheets in Billing

Billing

The Billing Module is represented by a dollar icon, and is where users are able to manage employee time tracking, set up billing permissions and rates, submit claims, produce invoices and post payments.

Sales

Information about Sales in Billing

Payments

Information about Payments in Billing

Miscellaneous

Information about the miscellaneous settings in Billing

Billing / Billing / Timesheets Adding Service Lines for an Appointment

Employees and administrators cannot manually add service lines to a timesheet during or after appointment conversion. The original timesheet needs to be edited after conversion and new timesheets need to be created. 

The example below is a scenario in which users need to add more service lines to an appointment:

  • An RBT has an appointment with a client from 9 AM-12 PM.
  • A BCBA will provide supervision for that appointment from 10 AM-11 AM without giving the RBT notice.
  • The insurance company does not pay for the concurrent billing.

In this example, the BCBA’s time in that overlap will be billed versus the RBT. Both of these appointments will need to be created and converted. Here is how it is set up:

  • RBT Appointment
    • Provider: RBT
    • Client: Client receiving services
    • Time: 9:00 AM – 12:00 PM
    • Code: Direct (Billable) (will be named differently depending on the organization).
  • BCBA Appointment
    • Provider: BCBA
    • Client: Same client receiving services from RBT
    • Time: 10:00 AM – 11:00 AM
    • Code: Supervision (Billable) (will be named differently depending on the organization).

To create and convert the appointments above:

  1. In a billing admin’s account, navigate to the Billing module and select Billing
  2. Choose a date range to filter the grid and filter by client, if needed
  3. Click the Filters tab on the left-hand side and select the Audits drop-down
  4. Select By Client next to “Overlap”
  5. Find the overlapping timesheets for the client and note the following:
    • What time were direct services provided?
    • What time did supervision occur?
    • What time was the overlap?
  6. Create a timesheet for the non-billable time of overlap for the RBT:
    • Provider: RBT
    • Client: Same client receiving services from the original timesheet.
    • Time: 10:00 AM – 11:00 AM 
    • Code: Non-billable Overlap Supervision Code (will be named differently depending on the organization).
  7. Add another service line for the remaining billable time from the RBT.
    • Provider: RBT
    • Client: Same client receiving services from the original timesheet.
    • Time: 11:00 AM – 12:00 PM
    • Code: Direct ABA (Billable) (will be named differently depending on the organization).
    • Note/Form: If a Note Template is required, attach the Note/Form created from the original timesheet in the Select existing note drop-down, instead of starting a new note.
  8. Navigate to the Billing module and select Timesheets to return to the original billing entry/timesheet made by the RBT
  9. On the right-hand side of the timesheet, click the gear icon and select Edit Timesheet
  10. Edit the time worked from 9:00AM – 10:00AM.
  11. Click Submit to save the changes

If the supervision happened in the middle of the appointment, a timesheet must be created for the remaining billable time by the RBT.

If the supervision happened at the start or end of the appointment versus the middle, only edit the original timesheet to start or end when the supervision begins. A non-billable timesheet will then be created for the RBT for that overlap time, so that they will be paid for that time, but it will not be billed.

Billing Creating New Service Codes for Telehealth

Users should reach out to their payor before setting up their account, to find out what is required for Telehealth, in terms of claims. Users should then set up their accounts based on what the payor requires. 

The following steps are suggestions for organizations. Click here to watch the “Telehealth Set Up: Create New Codes” webinar.

To create new service codes:

  1. Create a service code
  2. Add service code properties:
    • Code: the service code being duplicated
    • Description: it is recommended to add the word “TELEHEALTH” in all caps before the start of the description, to make it clear to use this code for Telehealth services only.
    • Default Service Location: Selecting 02: Telehealth will pull the location into all timesheets for employees using this code. Only add a location here if all payors linked to this code are asking for this specific location. If they are not, leave this as none and set the location by payor in the fee schedule.
    • Procedure Info: if providers ask for modifiers, select Optional. This will pull modifiers into the timesheet.
  3. Add any note templates needed and click Save
  4. In the Service Codes grid, add or create any service code labels to the new code. 
  5. Select the number under the “Default” column to add Default Rates.
  6. Click the Actions drop-down and select Set Default Rate
  7. In the “Fee Schedule Default Rate” pop-up, select a fee schedule and enter the rates for this service.
    • Agreed Rate: if there is no agreed rate, make it the same as the billed rate in the “Rate” field.
  8. Click Add
  9. If the payor requires a modifier or if rates differ by credentials, click the gear icon under the “Options” column on the right-hand side and select Add Modifier Group.
  10. In the “Add Modifier Group” pop-up:
    • Name: it is recommended to add “Telehealth”
      • If rates are different by credentials, create a Modifier Group with each credential and state in the name. For example, Telehealth- BCBA.
    • Location: users can add the “02: Telehealth” location if the payor requires this and it is not set in the service code Properties.
    • Enter the rates that for this payor.
      • Agreed Rate: if there is no agreed rate, make it the same as the billed rate in the “Rate” field.
  11. Click Add
  12. To set employee rates, select Custom Rates in the Service Codes grid
  13. Click the Actions drop-down and select Add custom rate
  14. In the “Add Custom Rate for:” pop-up:
    • Employee: add the employee 
    • Rate: users should not enter a client rate. Leave this blank if it is not needed.
      • Entering Client Rates will override what is set for the payor in “Default Rates.” Any modifiers added for the payor will not pull in.
  15. Click Add Rates
  16. Users can also add employees by pay codes if they are subscribed to the Human Resources module. 
  17. If the payor does not provide a new separate authorization with new authorized amounts for Telehealth services and the client must use the current authorization and the remaining amounts they have, put the service code(s) in the existing authorization. The new code should be put in with the group of codes they must share the remaining utilization with. 
    • Navigate to the Billing module and select Authorizations
    • Find the service code they must share the amounts with and select the paper icon on the right-hand side to open the authorization and to that specific group of code(s). 
    • Select the Service Codes tab and add the new Telehealth service code. 
  18. When scheduling new appointments, the employee creating the appointments should pick the code with the word “TELEHEALTH” for the Telehealth services. Both codes will be provided in the authorization, so it is very important to take your time when selecting these codes. 
  19. To update existing appointments without the Telehealth code to the new Telehealth code, use the View as Grid screen to filter for any appointments with the old code and open the appointment details to change to the new code. Users can create a new appointment type for Telehealth or add “Telehealth” to the appointment name.
    • Add the Telehealth authorization.
    • Click Update Appointment
    • Convert the appointment, review the timesheet, and click Save.
  20. If the payor provides a new separate authorization, create a new authorization.
    • This means that there will be two authorizations valid for one client if they had one already on file.
    • It is not recommended to delete anything involving authorizations. Once deleted, it cannot be brought back.
    • It is recommended to expire the non-Telehealth authorization to the day those services stopped. Please note, users have to go into each group of codes in the authorization and expire each one. The Global Settings cannot just be expired, as it will not apply to each individual group of codes. 
      • The new Telehealth authorization will start the day after the other authorization ended. This will not provide the employee with the option to select the wrong authorization and nothing will be deleted that could be used in the future.
    • After Telehealth Services are no longer being provided to the client, bring back the old authorization if the new authorized amounts are not being provided. This has to be done for each group of codes in the authorization. Editing the Global Settings for the date range does not apply to each group of codes.
  21. Delete the service code that was just created, but keep the authorization.
    • Deleting the code and keeping the authorization(s) intact will prevent employees from using the code. This keeps the utilization of those services up to date and untouched.
    • Anything that is deleted from an authorization cannot be brought back, but, deleted service codes can be.
  22. Update any existing and unconverted appointments from when Telehealth services will no longer be provided back to the original code from the original authorization. Or, if a new authorization is provided, update the appointment(s) with that new one.

Click here to learn how to set up modifiers for Telehealth.

Billing How to Download the Reconcile Payments Report

The Reconcile Payments report contains all of the information about reconciled payments posted to billing entries and bank deposits in the  Billing module.

To export the Reconcile Payments report:

  1. Navigate to the  Billing module and select Reconcile Payments
  2. Select any desired filters and a date range, by clicking the All Dates drop-down
  3. Click the cloud  icon on the right-hand side and select CSV or Text file
  4. Click  Download in the “Export” pop up to download the report to your computer, or Go To Files to be directed to the  Files module. The file will also be located in the  Files module

Click here to learn how to reconcile payments.

Billing / Scheduling Place of Service Auditing

To audit service codes for Place of Service:

  1. Navigate to the Billing module and select Service Codes
  2. Apply any desired filters 
  3. Click the cloud icon on the upper right-hand side and select CSV or Text file
  4. Click Download in the “Export” pop-up to download the file to your computer
    • The file will also be located in the Files module.
  5. Open the file and find column “AV”, for Place of Service

To filter for a specific Place of Service within Excel:

  1. Select column AV 
  2. Select to Sort & Filter at the top right of the Excel spreadsheet
  3. Choose Filter
  4. Click the drop-down arrow on column “AV”
  5. Choose the Place of Service to filter for

To audit billing entries for Place of Service:

  1. Navigate to the Billing module and select Billing
  2. Apply any desired filters, such as date range and labels
  3. In the “Location” column, click the horizontal lines and select the Place of Service to filter for
    • If the Place of Service is not appearing, there are no entries with that Place of Service and applied filters.
  4. Edit the Timesheet, if needed

To audit appointments for Place of Service:

  1. Navigate to the Scheduling module and select View as Grid
  2. Remove the Principal on appt filter
  3. Apply any desired filters, such as date range and labels
  4. Open the Filters tab on the left-hand side by clicking the funnel icon
  5. Select Filters
  6. Open the Appointment Information drop-down
  7. Find Place of Service and click the Choose drop-down
  8. Select the Place of Service
  9. Update appointments, if needed

Click here for a webinar on auditing Place of Service (POS) codes.

Billing Setting Up Modifier Groups for Telehealth

Users should reach out to their payor before setting up their account, to find out what is required for Telehealth, in terms of claims. Users should then set up their accounts based on what the payor requires.

The following steps are suggestions for organizations. Click here to watch the “Telehealth Set Up: Modifier Groups” webinar.

To add a modifier to a service code:

  1. Navigate to the Billing module and select Service Codes
  2. Select a service code that will be used for Telehealth and click the number under the “Default” column to open the fee schedules associated with that code.
  3. Create a modifier for every location the service code will be used at and/or for the different credentials that are paid at different rates. Click the gear icon in the “Options” column on the right-hand side and select Add Modifier Group.
    • Please note, if there is only one Modifier Group linked to the fee schedule, any client with that payor using the service code will have that one Modifier Group automatically applied to the timesheet. If not all services for that payor/service code are provided with Telehealth, create another Modifier Group for those standard services.
  4. In the “Add Modifier Group” pop-up:
    • Name: add a name, such as “Telehealth”
    • Location: select 02: Telehealth IF required by the payor, or add another location that is required. This can be left blank if they are not requiring a location. The Modifier Group does not need to be saved.
    • Modifiers: reach out to the payor to see if they take modifiers and if they require a specific order, and set this up based on their requirements. This can be left blank if none were provided. The Modifier Group does not need to be saved.
    • Rate: add the rates that you as an organization bill for the service.
    • Agreed rate: add the rates that were agreed upon with the payor. If there is no agreed rate, make it the same as the billed rate in the “Rate” field.
  5. Click Add
  6. Users can add “Telehealth” to appointment names or create an appointment type for employees converting these appointments. Or, users can create Scheduling labels to track which appointments are for Telehealth. 
    • These are recommendations to help with the tracking and auditing process if services are being provided with and without Telehealth.
  7. During conversion, the modifier groups linked to the fee schedule will be listed for the employee to choose, depending on where/how the service is being provided.
    • Please note, if there is only one Modifier Group linked to the fee schedule, it will automatically default to that Modifier Group and the employee will not have to choose.
    • This setup will require warning and training employees filling out these timesheets if they have to choose between more than one linked Modifier Group.
  8. Complete the timesheet according to the organization’s requirements and workflows. Click Save or Save and Return.
  9. To audit the timesheets, navigate to the Billing module and select Billing
  10. Select the correct date range and any necessary filters, such as Service Code Labels and Billing Labels. It is recommended to filter down by payor/service code and audit for what is required, such as the Location and/or Modifier(s).
  11. To audit for modifiers, select all of the billing entries in your search. Click the Actions drop-down and select Bulk-merge claims, but do not generate the claim yet. In the bulk generation screen, open each claim by selecting the >  arrow to view if any modifiers are attached to those entries. Add or remove any modifiers as needed and required by the payor.
  12. To audit for the location, look for the “Location” column and select the hamburger icon on the right-hand side of the blue word “Location”. This shows all of the locations that are applied to the billing entries with the current filters. Users can also click Locations on that same column to filter for any billing entries that do not have a location set. There are two ways to add or edit the location:
    • To add/remove Telehealth to the location, select the gear icon under the “Options” column on the right-hand side and select Edit Timesheet. Select the service line and edit the Place of Service. Click Save or Save and Return.
      • After refreshing the Billing screen, the entry will be updated.
      • Please note, this action is for billing admins.
    • Or, users can generate the claim(s). When the claim is generated, click the Actions drop-down on the right-hand side in the “Claim Manager” and select edit the claim. When the claim is open, click the Services tab and select each service line to edit the location. Click Save Claim.

13. Once auditing is completed, generate the claim(s).

When the Telehealth modifier is no longer needed, remove the Modifier Group from the default rate. Billing entries created before the Modifier Group is deleted will remain as is, because billing entries keep historical data.

Click here to learn how to delete a modifier linked to a default rate.

Click here to learn how to create new service codes for Telehealth.

Billing / Insights / Reports Viewing and Downloading the RCM Report

With the RCM report, users can view revenue, payments, receivables, overpayments, resolutions, and payor trends. Click here to learn more about the RCM report.

To view the RCM report:

  1. Navigate to the Billing module and select RCM Report (Formerly Sales)
    • Or, navigate to the Insights module and select Report Home
      • Click RCM on the left-hand side
  2. Filter the report by:
    • Selecting the payor or client bubbles on the top of the report
    • Selecting a desired date range by clicking on the calendar drop-down
  3. Add the appropriate search filters in the Add filters… search bar. Hovering over the search icon will display a list of available filters. 
  4. Click on a red or blue bubble in each chart to view a summary of the over payments and receivables insurance information with the number of clients that have that plan, or clients’ information found in their Profiles.

5. If the report is filtered by payor, clicking the “+” next to the payor’s name in the “Name” column of the grid will open another line level of clients’ IDs that have that insurance. Clicking the “+” next to a client’s ID will open another line level of the date of service.

  • If the report is filtered by client, clicking the “+” next to the client’s ID in the “Name” column of the grid will open another line level of the clients’ insurance. Clicking the “+” next to the client’s insurance will open another line level of the date of service.

6. Click the “Insurance” and “Patient” columns in the grid to sort by:

  • ↑: ascending order.
  • ↓: descending order.

7. The report can also be exported and downloaded to your computer.

To download the report:

  1. Click the cloud icon on the top right-hand side and select CSV or Text file
  2. In the “Export” pop-up, select Go To Files to be directed to the Files module
  3. Click on the file and select Download File
  4. Click on the link to download the file to your computer

Billing / Insights / Reports Viewing and Downloading the Receivables Report

With the Receivables report, users can view overpayments and receivables by payor and client. Click here to learn more about the Receivables report.

To view the Receivables report:

  1. Navigate to the Billing module and select Receivables Report
    • Or, navigate to the Insights module and select Report Home
      • Click Receivables on the left-hand side 
  2. Filter the report by:
    • Date of service or first billed
      • Please note, currently, only “date of service” links to the Billing module.  
    • Net, outstanding, or overpayments
      • On the left-hand side, “AR Outstanding,” “Over Payments,” and “AR > 90 Days” changes based on the selected filter.
    • Sorting by payor or client
  3. Add the appropriate search filters in the Add Filters… search bar. Hovering over the search icon will display a list of available filters.
  4. The circular, triangular, and diamond shapes represent primary, secondary, and tertiary insurance
    • Select a shape to view a summary of the insurance information with the number of clients that have that plan, or clients’ information found in their Profiles.

 

5. In the “Aging Breakdown,” clicking each “color” will open up a summary of information in each aging bucket.

6. If the report is filtered by payor, clicking the “+” next to the payor’s name in the “Name” column of the grid will open another line level of clients’ IDs. Clicking the “+” next to a client’s ID will open another line level of the date of service.

  • If the report is filtered by client, clicking the “+” next to the client’s ID in the “Name” column of the grid will open another line level of the clients’ insurance. Clicking the “+” next to the client’s insurance will open another line level of the date of service.

  • There is a “Totals” row when clicking the “+” next to each date of service, as well as a total amount for all clients with that payor.

7. Click “Insurance” and “Patient” in the grid to sort by:

  • ↑: ascending order.
  • ↓: descending order.

8. The report can also be exported and downloaded to your computer.

To download the Receivables report:

  1. Click the cloud  icon on the upper right-hand side and select CSV or Text file
  2. In the “Export” pop-up, select Go To Files to be directed to the Files module
  3. Click on the file and select Download File
  4. Click on the link to download the file to your computer

Billing How to Make a Payor Inactive

You cannot delete a payor that is no longer being used, however, the organization account can make payors inactive, to prevent employees from using them.

To make a payor inactive:

  1. Navigate to the Dashboard module and select Home
  2. Click My Profile and select EXT.Profile
  3. Click Accepted Insurances and click the x to the right of the payor you are no longer using
    • Please note, this affects the future use of the payor. As long as timesheets are already created and saved with that payor, making a payor inactive should not affect the rebilling of claims

Billing Building a File to Import to QuickBooks

CentralReach does not offer a standard integration with QuickBooks. However, we can support with the building of an .iif (Intuit Interchange Format) file, which will be useful if the version you have allows uploads. Importing and exporting .iif files created by QuickBooks is rather simple, because QuickBooks formats the file for you. It may be easier to manually enter the data directly into QuickBooks, unless you have large amounts of data to input.

  • Please note, that .iif files are irreversible, and it is recommended to back up your company files before trying to import any .iif files into QuickBooks. This way, if any errors should occur while importing the file you can restore a backup of your company files

Creating a .IIF file:

To start off, determine what information you want to pull from CentralReach and have appear in your .iif file. CentralReach allows you to download various information, which you can export to a .CSV (Excel) file, that you can then convert to an .iif file. The initial steps you take to download the information from our system will depend on what data you are trying to collect and import into QuickBooks.

To download billing information from our billing screen and convert that data into an .iif file:

  1. Navigate to the Billing module and select Billing
  2. Select the date range you want to download and pull from our system, then download the billing screen
  3. After following those instructions, you should have an open Excel file populated with information from your billing screen
  4. Once you have this document created, you can modify it
    • You can delete any columns/fields within the document that you do not want or need
  5. After you have edited the document and removed all unwanted information, you will need to modify the column names. QuickBooks column names are very specific. In order for your file to properly import into QuickBooks, you will need to use the appropriate column names

  • For Example, If you look at the image above, the date column is labeled “DateOfService.” That would need to be changed to read “DATE” because that is the column name that QuickBooks will recognize as a date field. If it were to be left as “DateOfService,” when you went to import your file into QuickBooks, it would not read/upload the file properly
  • The column names you will need to use will be specific to what area of QuickBooks you are trying to upload your .iif file to and what information is contained within that file.

6. Once you have your document fully edited and ready to be uploaded into Quickbooks, you will need to save it as an .iif file. To do this within Excel you will need to click File, and then Save As

2015-07-07 13_41_44-Spreadsheets - [088a3e48eb0440928671f07bb9aaecb4.csv _]

7. A new window will pop-up. In the Save as type drop-down menu, select the option that allows you to save your document with an .iif file extension. Some older versions of Excel may not give you the option to save the document as an .iif file. In this situation, you will need to save it as a Text(Tab delimited).TXT file

2015-07-07 13_55_46-Spreadsheets - [88a3e48eb0440928671f07bb9aaecb4.csv]

8. If you are able to save the file as an .iif file, it is ready to be imported into QuickBooks. If you have to save it as a .txt file you will then need to:

  • Close your file
  • Open windows explorer and locate your file
  • Left click on the file and select rename

2015-07-07 14_15_29-Documents

9. All you will need to change in the name is the file extension. So simply change .txt to .iif

2015-07-07 14_10_25-Spreadsheets - [88a3e48eb0440928671f07bb9aaecb4.csv]

10. Once you have completed this step, your file will be ready to be imported into QuickBooks

We understand that this process is a bit lengthy and slightly confusing if you are not familiar with formatting delimited text files. If you have any questions or need assistance in creating a specific template do not hesitate to open a support ticket.

Billing / Tasks Create a Task from the Billing Module

Create tasks directly from the Billing module to keep track and follow up on work pertaining to billing entries and authorizations, such as pending payments to be received from payors or authorizations that need to be renewed. Tasks include links to access the billing entries or authorizations they were created for.

To create tasks from the Billing module:

  1. Navigate to the Billing module and select Billing or Authorizations
  2. Click the checkbox  next to the billing entries or authorizations you want to create a task for
  3. Click the Actions drop-down and select Add Tasks
  4. In the “Create task for X billing items” (if creating a task from Billing) or the “Create task for X authorizations” (if creating the task from Authorizations) pop-ups, complete the form with the following information
    • Name: name of the task
    • Description: a detailed description of the task
      • Click here if you are creating a task using a Task Template
    • When is it due?: enter the task due date
      • Assigning a due date will enable you to filter tasks in the tasks screen and in the main menu of the  Tasks module, by Due Today and Overdue
    • Who is responsible?: click the drop-down to select one of the following:
      • You: if the task is an assignment for yourself
      • Choose someone…: to assign the task to somebody else
        • Find Person/Group: enter the name of the person, group, or label the task should be assigned to
      • Leave unassigned: if the task should not be assigned to anybody. Use this option to create a queue of tasks that can be worked on and completed by other users in the organization
        • Who can see this task?: choose either All co-workers in my organization or Only providers matching a label
          • If choosing only providers matching a label, add labels in the Select Contact label search bar
    • Is this task on behalf of a person?: select one of the following:
      • Yes: if the task is being created on behalf of another person
        • On behalf of: enter the name of the person the task is created for
      • No: if the task is not created on behalf of another person
    • Add Labels: enter labels, which allow you to filter and organize your tasks
    • Attachments: click Upload, Select Files, or drag your the file to the Drop files here to upload to attach relevant documents to the task

5. Click Create Task

6. When accessing the task, the list of billing entries or authorizations the task was created for will be displayed on the bottom right-hand side of the task, with links to open and access each billing entry or authorization