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.

Billing / Billing “The Referenced Transaction Does Not Meet the Criteria for Issuing a Credit”

When attempting to process refunds you will receive the, “The referenced transaction does not meet the criteria for issuing a credit” message.

This message can mean one of three things:

  • The original transaction has not settled yet (usually takes about 24 hours)
  • The refund is more than the original transaction
  • The original transaction is more than 90 days old

Click here to learn how to refund a credit card payment.

Actions

Allows you to bulk lock/unlock, generate invoices, apply copays, sign, merge claims, and add tasks *Note: this button only appears when you have multiple billing entries selected

Billing / Billing Export

Export the billing entries that are within the current date range selected into either a CSV or text file.

Click here to learn how to export the Billing report.

Billing / Billing / Billing / Timesheets / Filters Files Column (i.e. 1, 2, 3….)

Clicking on the number associated with the files column redirects users to the Files module and filters the system to show the file(s) associated with that billing entry or timesheet.

Billing / Billing Grouped Entries Column (i.e. 1, 2, 3…..)

In the Billing section of the Billing module, the “Grouped Entries” column (represented by an icon) is located on the left-hand side of the grid and contains a number if the billing entry is grouped together. Select the number to view the grouped billing entries.

Billing / Billing Load Totals

View the total amounts for all billing entries on the screen.

Billing / Billing Locked/Unlocked

Individually lock or unlock a billing entry to allow for timesheet edits.

Click here to learn how to lock and unlock a timesheet.

Billing / Billing Payor Column

Edit the payor that is currently associated with that billing entry.

Click here to learn how to change a payor from the Billing screen.

Billing / Billing / Permissions Permission to View Client’s Rates

Employees with the following Billing module permission, can view clients’ rates when converting an appointment into a timesheet. This permission can be granted via the Permissions module, and allows employees to have access to Service Codes and Fee Schedules:

  1. Settings > Manage
    • Access to billing settings, including the ability to see employee pay rates and Client charge rates

Billing / Billing PR Amt. Column

Change the patient responsibility amount that is currently associated with that selected billing entry.

Click here to learn how to add the PR Amt. Owed.

Billing / Billing Tasks Column (i.e. 1, 2, 3….)

Clicking the number in the tasks column will open a pop-up window that shows all tasks associated with that billing entry. Open a specific task to re-assign, complete, copy, delete, cancel, or add a comment.

Billing / Billing The ESSC Report

The ESSC report is used to bill services to Easterseals Southern California (ESSC). 

Below are columns found in the ESSC report:

  1. Appointment ID: the unique ID created for the billing entry.
  2. Employee ID: the unique Id created for the CR employee on the billing entry.
  3. MRN: the medical record number, or the Subscriber ID.
  4. Authorization Number: the authorization number for the service code on the billing entry.
  5. CPT Code: the name of the service code.
    • Please note, the name is not the same as the description for the service code.
  6. Service From: the start date on the billing entry. This displays in the MM/DD/YYYY format.
  7. Service From Time: the start time on the billing entry. This displays in the HH:MM:SS AM/PM format.
  8. Service To: the end date on the billing entry. This displays in the MM/DD/YYYY format.
  9. Service To Time:  the end time on the billing entry. This displays in the HH:MM:SS AM/PM format.
  10. Service Duration: the number of minutes of the service on the billing entry.
  11. Treatment Type: the modifiers attached to a service code, which are Direct (DI), Indirect (IN), Low (LO), Moderate (MO), and High (HH). CentralReach recommends using modifier groups for the five treatment types.
    • Please note, if there are no modifiers, the place of service will determine whether the Treatment Type is “Direct” or “Indirect.” If the place of service is “11: Office,” then the Treatment Type will be “INDIRECT.” For all other places of service, including if this field is left blank, the Treatment Type will be “DIRECT.”
  12. Client Name: the client’s full name. This displays as “first name last name,” such as “John Smith.”
  13. Staff Name: the provider’s full name. This displays as “first name last name,” such as “John Smith.”
  14. POS: the place of service. This displays as “Place of Service,” such as “Telehealth.”

Click here to learn how to download the ESSC report.

Billing / Billing Units Showing as Whole Numbers

When viewing the Billing and Timesheets page, the hours column displays correct decimal values and the units column only displays whole numbers. The reason is, units are always rounded to the nearest whole number. This means that if the service duration exceeds 50% or more minutes per unit, the unit will be rounded up to the next whole digit.

  • For example, if your minutes per unit is set to 60 minutes, yet the total service time was 1 hour 30 minutes, then the system will round the total units to two

Some helpful calculations:

  • If a service code is set to 15 minutes per unit: every 0 – 7 minutes= 0 units; every 8 – 15 minutes= 1 unit
  • If a service code is set to 30 minutes per unit: every 0 – 14 minutes= 0 units; every 15 – 230 minutes= 1 unit
  • If a service code is set to 60 minutes per unit: every 0 – 29 minutes= 0 units; every 30 – 60 minutes= 1 unit