PRESENTED BY ISAAC KAUFMANPRESENTED BY ISAAC KAUFMANDECEMBER 3, 2013DECEMBER 3, 2013

Part B Billing and the Rehab Button

Topics IncludeTopics Include

Charge Master: Auto download of Part B rates (OFU 34.09)

How to enter a therapy charge

Entering the private and part b rates

Entering the hcpcs/cpt codes

Entering modifiers

Entering the MPPR rate Rehab Extraction including creating, editing and posting the rehab batch.

Vendor file import. Auto KX Modifier. Onset, Start, Plan dates. Paysource and Part B Flags. Part B Billing including use of the Rehab button.

Charge MasterCharge Master

Ancillary Charges folder/Charge Master , Insert.

Charge MasterCharge Master

Enter the Charge Code, Description, Revenue Code (RC), Unit Cost and From Date.

Charge MasterCharge Master

Enter the HCPCS code and Modifier. Save. The system will ask if you want to update the orchd table.

Charge MasterCharge Master

To Enter the MPPR rate – Click Edit.

Charge MasterCharge Master

Flag the Paysources and enter the MPPR rate.

Vendor File ImportVendor File Import

The vendor file must be in the specified format and placed in the ADL user folder. Enter the file name in the Input File field and

press OK.

Rehab ExtractionRehab Extraction

The rehab charges that were entered by the therapists can be extracted from either of two locations.

Ancillary Charges folderAncillary Charges folder

Ancillary Charges folder/Rehab Extraction or from the Rehab Module/Rehab Extraction.

Rehab ModuleRehab Module

Rehab ExtractionRehab Extraction

Enter Service in datesEnter Service in dates

Dates can only span one month. The extraction displays the Batch. Look for Errors & Warnings.

Client LogClient Log

Select Client Log to display details such as the resident’s Account number, Date of Service, Minutes, Department & Description.

Therapist LogTherapist Log

Therapist Log displays the charges by therapist. The Therapy Cap Status Report displays the accumulated billed/unbilled charges.

ErrorsErrors

Errors must be corrected prior to saving the batch. Error: No charge code found in table ORCHD means this code is not

present in the Tx-Charges Table (Clients). No Price on G Code-.01.

Tx-Charges Table (Clients)Tx-Charges Table (Clients)

The lower left grid is a lookup into the charge master. Place the cursor on the line (upper grid-line 33), double click the charge code

in the lower grid.

Tx-Charges Table (Clients)Tx-Charges Table (Clients)

The minutes need to be entered. Save the changes.

Re Run the Rehab ExtractionRe Run the Rehab Extraction

The error has been addressed. Correct all errors and save the batch.

Rehab Extraction-PostingRehab Extraction-Posting

Saving the extraction creates the ancillary batch to post. The batch file name is displayed.

View/Print the BatchView/Print the Batch

There must be at least one Dx for each charge.

Post the BatchPost the Batch

Enter the Posting Date, check Post Clients not In-House on date of Service, select the batch, click Post.

PostedPosted

Log File 1 contains the posting receipt with the batch detail. Log File 2 contains unposted charges. These need to be addressed and

posted.

Log File 1Log File 1

Log File 2Log File 2

Auto KX ModifierAuto KX Modifier

Billing/Billing Wizard/Part B.

Auto KX ModifierAuto KX Modifier

This setting allows the system to apply the KX modifier once the amount entered here has been reached.

Onset, Start, Care Plan datesOnset, Start, Care Plan dates

A parameter allows this data to flow from the therapists touch screen. The KX Check box displays based upon the rate set for the

Auto KX. Accumulated amounts billed/unbilled are displayed.

Paysource and Part B FlagsPaysource and Part B Flags

Select the Part B Paysource from the drop down menu.

Paysource and Part B FlagPaysource and Part B Flag

Select the Part B flag: N=None, B=Both, D=D Only, B=B Only.

Part B Billing/Rehab ButtonPart B Billing/Rehab Button

Billing/Billing Wizard/Part B/partbb

Part B Billing/Rehab ButtonPart B Billing/Rehab Button

If the Onset, care and/or Start dates were entered after the treatments were administered, press the Rehab Button to pull them to the billing.

Part B Billing/Rehab ButtonPart B Billing/Rehab Button

Press the Process button. Care Plan dates displayed will go to billing for records with a check in the X field.

Part B Billing/Rehab ButtonPart B Billing/Rehab Button

Select All Residents, enter the Bills dated date, For the Period, Tape Info=Diskette, Repayment Percentage and the Paysource that you are billing. Do Not check Post to transaction files until the bill is

error free.

Part B Billing/Rehab ButtonPart B Billing/Rehab Button

Review the Stay report for errors.

Part B Billing/Rehab ButtonPart B Billing/Rehab Button

Correct all errors and re run the partbb until the stay report is error free.

Part B Billing/Rehab ButtonPart B Billing/Rehab Button

PBSUMR Report

Part B Billing/Rehab ButtonPart B Billing/Rehab Button

PARTBB (UB-04 O4 Bills). Click the PDF Viewer.

Part B Billing/Rehab ButtonPart B Billing/Rehab Button

UB-04 In the PDF Viewer.

Edit/Print UB-04Edit/Print UB-04

To edit and print UB-04’s expand the Billing folder/Reports/Edit UB-04s.

Edit/Print UB-04Edit/Print UB-04

Select the UB or UB’s you want to edit and/or print, right click on the menu and select desired action from the list.

Edit/Print UB-04Edit/Print UB-04

The UB-04 displays. Any field can be edited, saved and printed.

Part B Billing/Rehab ButtonPart B Billing/Rehab Button

Re run the Generate Part B bills process again this time, select Post to transaction files to post