Billing Process Work Flow

After charges are applied to an encounter, you can:

• Bill the encounter to the guarantor (for encounters with no attached insurance)

- or -

• Bill the encounter to a payer (for encounters with attached insurance).

You can bill only those encounters with an Unbilled (U) or a Rebill (R) encounter status.

To bill a single encounter, access the Chart > Encounters tab, right-click on the encounter you want to bill, and select Bill from the menu.

To bill multiple encounters at once (Batch billing), access the Encounter Lookup window, enter search criteria to locate Unbilled encounters, select the encounters you want to bill from the list of matching records, right-click and select Bill from the short-cut menu.

You can review the charges applied to the encounter in the Encounter Bill window.

For encounters with insurance, the application generates a claim by checking the encounter against the Claim Edits that are configured in the Claim Edits library. The results of this Claim Edit check display in the Claim Production Status report. If the edit check discovered errors, you might be required to modify the encounter and then bill it again.

For encounters with no insurance attached, the application generates an Itemized Bill (Encounter Bill) that is addressed to the encounter guarantor.

Then send the claim to the payer or the Itemized Bill (Encounter Bill) to the guarantor.

When you receive payment, you must post the payment to the encounter. The application records the payment as a transaction with the encounter.