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CONNECTICUT DSS ELECTRONIC VISIT VERIFICATION (EVV) PROGRAM PROVIDER TRAINING: BILLING
July – August 20168
Connecticut DSS Electronic Visit Verification (EVV) Program Provider Training: BillingJuly 2016Slide 2
AGENDA1. Billing Overview2. Not OK to Bill Process3. Getting Ready to Bill4. Creating Invoices5. Creating a Billing Export
Connecticut DSS Electronic Visit Verification (EVV) Program Provider Training: BillingJuly 2016Slide 3
Billing Module
The Billing module allows for the review of visits which are eligible for invoicing and visits which are confirmed but still have conflicts. Review the confirmed visits for billing Create the invoice Review and print Billing Summary report Export invoices
Connecticut DSS Electronic Visit Verification (EVV) Program Provider Training: BillingJuly 2016Slide 4
Billing Overview
Click Billing from the menu barThe Billing Review screen displays all visits that have been confirmed for the date range selectedFilters include Payor, Admit Type, Service, Client and Date Range
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Connecticut DSS Electronic Visit Verification (EVV) Program Provider Training: BillingJuly 2016Slide 5
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Investigate Not OK to Bill
Check Show Only Items NOT OK to Bill.Displays confirmed visits for which invoices cannot be created.NOT OK to Bill reason must be cleared in order for invoice to be created for the visit
Providers Served
Connecticut DSS Electronic Visit Verification (EVV) Program Provider Training: BillingJuly 2016Slide 6
Getting Ready to Bill
In order to be ‘OK to Bill’ schedules must meet the following criteria: Valid Authorization Schedule matches the authorization Service was provided according to the authorization Caregiver call times match the schedule or in the case; of an
exception, the schedule was manually confirmed A primary diagnosis was entered in the client’s profile No open physician signature holds on the client’s authorization
(medical services only)
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Connecticut DSS Electronic Visit Verification (EVV) Program Provider Training: BillingJuly 2016Slide 7
Holding a visit from Billing
A visit that is ‘OK to Bill’ can be held from billing if additional review or adjustment is needed. From the Billing Review screen: Locate the confirmed visit which needs to be held from billing Left click to highlight the visit line Right click on the highlighted line and choose: Set Status > Hold Select the appropriate Change Reason
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Connecticut DSS Electronic Visit Verification (EVV) Program Provider Training: BillingJuly 2016Slide 8
Creating Invoices
1. Select Show Only Items OK to Bill2. Select Billing period3. Click Update to ensure visits have the most
current rate information4. Click Create Invoices5. Set Invoice Date6. Select Print A Summary Report7. Click Create Invoices
Connecticut DSS Electronic Visit Verification (EVV) Program Provider Training: BillingJuly 2016Slide 9
BILLING EXPORT
Connecticut DSS Electronic Visit Verification (EVV) Program Provider Training: BillingJuly 2016Slide 10
Billing Export
The Billing Export screen is where the electronic invoice file is created.Hover your mouse over the Billing icon and select Export from the drop-down menu.
Connecticut DSS Electronic Visit Verification (EVV) Program Provider Training: BillingJuly 2016Slide 11
How to Export
1. Select the invoice date range to be exported.2. Check the 'Show Only Billable Items' box.3. Connecticut DSS will be pre-selected as the Payor to set the
format. 4. Click Export button, when ready.5. When prompted, save file to computer for uploading to
Connecticut’s portal
Connecticut DSS
Connecticut DSS Electronic Visit Verification (EVV) Program Provider Training: BillingJuly 2016Slide 12
Billing History
Once claims have been exported, the exports can be reviewed from the Billing History screen.
1. Hover over the Billing icon and click History.2. Click the (+) icon next to the folder to display or hide contents.3. Click to select an Export.
● Claims tab shows invoices that are part of the claim.● Raw File tab shows the actual formatted text file that was exported.
Connecticut DSS Electronic Visit Verification (EVV) Program Provider Training: BillingJuly 2016Slide 13
After Export
When the user click’s Export, a pop-up will appear prompting the user to open or save the file. The file should be delivered directly to the Connecticut EDI system.
The turnaround times and submission deadlines are not changed.
The 999 response file will be received by the EVV system and the results returned to the user.
The 277 files are routed back to the Provider using the current process.
Connecticut DSS Electronic Visit Verification (EVV) Program Provider Training: BillingJuly 2016Slide 14
DEMONSTRATION − Billing Module
Connecticut DSS Electronic Visit Verification (EVV) Program Provider Training: BillingJuly 2016Slide 15
LET’S REVIEW
Connecticut DSS Electronic Visit Verification (EVV) Program Provider Training: BillingJuly 2016Slide 16
What You Have Learned
Accessing the Billing Module and reviewing visits How to investigate ‘Not OK to Bill Visits’ ‘OK to Bill’ Schedules and the required criteria How to Create Invoices How to Create an Electronic Invoice File via the Billing Export
screen How to Export How to Review Claims Once Exported What Happens After an Export
Connecticut DSS Electronic Visit Verification (EVV) Program Provider Training: BillingJuly 2016Slide 17
Questions
Connecticut DSS Electronic Visit Verification (EVV) Program Provider Training: BillingJuly 2016Slide 18
How to Stay Connected
We look forward to working with you.Please do not hesitate to reach out with questions, comments or suggestions as we
move forward.
Telephone
(855) 399-8050
Websitewww.ctdssmap.com