Third Party Billing

Modified on Mon, 15 Jun 2015 12:13 by Kevin Ricciardo — Categorized as: Uncategorized

CAREWare has a Third Party Billing Module. This feature can be accessed on the Administrative Options menu in provider and ADAP domains.

Clicking the Third Party Billing button will open the Third Party Billing Administration menu as shown below. Initially the Third Party Billings buttons are grayed out until the Third Party Billing Module is enabled.

Check the box to enable the Third Party Billing Module.

Once enabled, the Third Party Billing Module Administration buttons will be active.

General Settings:

The general settings form allows billing administrators to turn the billing module on via the master switch, turn on the time to service unit calculator within the service data entry form, specify the number of decimal places to round the unit calculation to for storage purposes, and configure email recipients for nightly emails regarding billable services whose units are out of range. The email system will utilize the existing daily task system within CAREWare.

Email can be configured using the Email Recipients button.

Add Recipient:

Employee Setup:

The Employee Setup form can be updated to add staff as billing administrators and configure those staff as service providers. Their effective date, N5 and NPI codes are stored here.

Insurance Provider Setup:

The insurance provider setup lists the available insurance providers and gives billing administrators a way to activate/deactivate them using check boxes along with a way to configure settings for billing exports.

Add Insurer:

Service Setup:

The service setup gives billing administrators a way to mark subservices as billable, associate existing subservices with CPT codes and set other billing traits including the diagnosis code, modifier, and max units.

Edit Service:

Create Claims Data Set:

Billing operators can use the Claims File Generator to generate new claims data set files for specific date ranges and specify a directory to store them.

Claims Data File:

Billing Report Generation:

Clicking the Billing Report Generation button will open a new dialog from which Billing Operators can generate and work with claims data sets. Billing operators can review the insurance status of clients, review detailed service information, include/exclude individual service records, and generate billing reports.

The Billing Report Generation uses the Claims Data File for generating reports for the Third party Billing Module.

To download these instructions click here.

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