The following frequently asked questions regarding the BillingBuilder can be a useful reference when you have your own questions about the functionality.
PROCESSING - Can in person payments be used to record multiple payments toward a single service?
PROCESSING - How can I tell which services have been billed/not billed?
A data variable called Invoice ID (Batch ID) is available in the following Services module ReportBuilders for all agencies that use the BillingBuilder:
- Contacts Log ReportBuilder
- Group Notes ReportBuilder
- Progress Notes ReportBuilder
- Service Contacts ReportBuilder
When the Invoice ID (Batch ID) variable is included in one of these ReportBuilders and populated with data, it indicates that the service has been billed/invoiced (meaning that an invoice has been generated and posted to A/R for that service). If a service is associated with multiple posted invoices, all invoice IDs are reported in the order of the oldest to the newest invoice.
This data field is only populated for program services that are linked to configured billing types. AWARDS hard coded billing types/program services are not included.
PROCESSING - How do I troubleshoot a claim file if I receive a response file that indicates the claim has been rejected?
Once a 997 response file is uploaded, you will need to review the file to identify any errors that need attention. First find the original claim file whose submission resulted in receipt of the response file, and then parse that claim file so that you can identify the lines in it which have errors.
To parse a claim file, complete the following steps:
- Locate the claim file in the location to which you previously saved it - on your computer or in an external data location such as an external hard drive, CD, or DVD.
- Open the file as a Word Document.
- Press <Ctrl-F> to open the Find and Replace dialog box.
- Click the Replace tab.
- In the Find what field, enter a tilde (~).
- In the Replace with field, enter a tilde (~) followed by a manual line break symbol. (Manual line breaks are entered by clicking More on this dialog box, followed by Special, and then selecting "Manual Line Break.") The resulting entry appears as ~^|.
- Click Replace All. The claim file is parsed.
- Insert line numbers into the document. When using Word 2007, this can be done by clicking the Page Layout tab, and then clicking Line Numbers and selecting "Continuous." Otherwise, you can cut and paste the entire document into a Microsoft Excel file so that the lines can be counted there.
- Remove the first three lines (which contain header information), and then go to the lines specified in the 997 file to view the data elements in question.
- After identifying the lines with errors, make corrections to the billing setup or clinical documentation as necessary, and then create a new claim file using the original invoice batch.
The process of parsing and troubleshooting a claim file is now complete.
PROCESSING - I uploaded my 835 remittance statement and then created a remittance worksheet, but it does not show the same statuses on the invoice as in the 835. Why?
If you only upload the 835, but do not read it before creating the remittance worksheet, the worksheet will not recognize that an 835 is present. If you did just upload the 835, delete the worksheet, make sure to read the 835, and then create a new worksheet.
PROCESSING - When using the re-bill setting, how do the month and year selections affect the invoices that are generated?
When you generate a re-bill batch, AWARDS looks at the Month/Year selected to see what procedures to look for to re-bill. If you are re-billing for procedures that have an end date in the past, you may have to adjust these settings, since they default to the previous month of the current year.
PROCESSING - Why does a batch I posted a remittance worksheet for still display under open batches when I attempt to remit other batches?
Batches continue to appear under open batches in the remittance worksheet area if there are any pending payments or partial payments outstanding in the posted remittance worksheet. If you no longer want the batch to display, change the status of the pending invoices and partial payments, for example to paid, void, or re-bill.
PROCESSING - Why is the Billing Services Report not showing all of my posted invoices and payments?
The Billing Services Report will only be accurate if there are no "scratch" batches under BillingBuilder > Edit Invoice Batch. If there are any that aren't posted, delete them and the report will work correctly.
SETUP - How do I update changing billing unit type requirements to be effective on a future date (for example, changing from "monthly" to "fee for service")?
If billing unit type requirements will be changing on a future date, create a new billing type and configure that new type with the upcoming requirements. The procedures within the new billing type should have Effective Dates that correspond to the date the new billing type will be in effect. On the procedures in the billing type that will be phased out, enter Expiration Dates that correspond to the date the billing type will no longer be in effect. Leave the program billing groups as-is until the date of the switch. On the day the new billing rules become effective, place the appropriate programs in a new program billing group that is set to use the new billing type. After this tie, if you need to generate invoices for a date in the past using the previous rules, put the program back into the old group.
SETUP - What should be done if a billing rate needs to be updated?
If a billing rate has changed and a new one needs to be entered, follow the steps outlined in Configure Billing Rates. Choose the procedure that requires the rate update and enter a new effective date, then enter the new rate and save the page. The old billing rate is then archived. AWARDS will assign the new rate to any services with a service date on or after the effective date of the new rate, and will use the old rate for service dates before the effective date of the new rate.
SETUP - Why can I delete one billing procedure and not another?
A procedure can only be deleted when there are no invoices created for that procedure.
SETUP - Why is a service not being billed for by the BillingBuilder for a particular program?
If a service is not being billed for by the BillingBuilder for a particular program then you must investigate the program-specific setup options in the Billing Menu. Pay specific attention to the configuration of Program Billing Info and Billing Rates.
SETUP - Why is only one service for a consumer being billed for by the BillingBuilder per day?
If only one service is being billed for by the BillingBuilder per day, investigate the Billing Type configuration. If the Billing Unit Type for a particular Billing Type is Per Diem, then it will prevent Fee For Service billing types from being billed for that program for that day (so long as they are less in value).
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