In order to ensure that AccuPoint’s clients are running the most efficient report to ensure that all billing is submitted correctly and in a timely manner – AccuPoint has created the below billing best practices guide:
1. Any new services should be requested by using the AccuPoint Billing Information Sheet. By using this sheet, this ensures that AccuPoint is communicated the required information in order to properly bill the services.
2. All new services should be monitored for payment / acceptance after they are added into the AccuPoint system. Similar to the initial test billing that was done when you started with AccuPoint – you are going to want to ensure that the claims are being paid, and paid correctly. Any issues should be addressed / communicated to the AccuPoint team immediately.
3. Insurance Numbers: This area of the site is used to store the subscriber number information for the insurance subscriber. The edit information page of the client from the dashboard is used to store the patient information. Depending on your site configuration, most sites will automatically copy over the information from the client’s edit information profile into the insurance numbers list at the time that billing is ran. As insurance information changes – the information can be terminated and a new insurance number can be created. Additionally – if information was entered in incorrectly at the time a new client is added in – it will need to be updated in the insurance information or insurance numbers list as well for billing to be sent correctly. This is inclusive of all key demographic information needed for billing; name, birthday, gender, address, etc…
4. The following reports should be generated to ensure that there are no items “stuck” in the AccuPoint system after a billing batch is generated. With all of the below reports, date filters and service filters can also be used in order to better streamline results that you are looking for:
a. Pending and Ready to Bill Yes Report – specifically choosing Status: Pending and Ready to Bill: Yes. Items in this status may be missing key demographic information in the edit information profile that restricts the system from being able to generate a billing item for it. This should be reviewed internally and if it cannot be resolved, the AccuPoint support team should be contacted. b. Error Report – After every time a billing batch is ran – any errors not allowing claims to be transmitted to the clearing house will show up in this report. You may also check off “Show Errors” which will give you a hint as to why it may not be transmitted. This usually has to do with an incorrect entry in the insurance numbers list. Errors are also included in here that are received from Remittances (ERA’s) from the payer. These items need to be researched and resubmitted. If an item says “AP Error” that means it was an error generated by AccuPoint. AccuPoint errors will automatically clear when they are resolved and a billing batch is sent. Payer errors need to be marked as ready to bill and they will be cleared during the next billing batch. c. Pending and Ready to Bill No Report – This report will pull up all items that are ready to be billed out but are pending approval. These items should be revised regularly to ensure that timely filing limits are not reached. d. Hour Change Next Bill Report – This report will show you items that were billed, and after that point in time, the number of units were revised. These items need to be rebilled as a frequency 7 type claim – void and replacement. To send them out – please mark them as ready to bill. Please note – you cannot send these out revised claims until a remittance is received or the TCN is manually entered. The first time a revised claim is submitted for a specific payer; the claim should be tracked to ensure it is revised correctly as certain payers do not handle electronic adjusting claims. e. Billed Report – Best practices is to run a billed report using a filter of “billed date” that shows all claims that were billing longer than XX days – whereas XX days is the number of days of your typical payment cycle. Keep in mind – this is only accurate if you are receiving electronic remittance files from this payer / are posting the paper remittances to Accupoint in a timely manner. Anything showing on this report should be investigated to determine why payment has not yet been received. If an item needs to be resubmitted – it may be changed back to pending. If you log into the MDOL portal – you can also search by date of service and client last name to find the status in the clearing house. f. MDOL Portal – AccuPoint clients should review the MDOL portal for rejections at least once per week. These claims may be shown as rejected and an ERA may not be generated for them. The errors can be resolved in AccuPoint and then resubmitted by marking the claims back to pending. g. Items in Audit status – Running a calendar filter with the query inclusive of items in audit will show you items that were unable to be sent to billing due to compliance issues or items that need additional review based on permission levels. These will not be billed until the audit status is resolved. h. Items in Entered status – running a calendar filter with the option of entered items will show you shifts that were scheduled but never completed. This could have been that the items were served but the time sheets were never completed / completed by the staff – which could result in a loss of reimbursement for those shifts. This could also indicate that the schedule is out of date so the items were not completed.Feedback
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