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Billing Module

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Q: Does it auto code for us and generate a HCFA form?

A: The billing module includes the ability to create FeeSlips from which you click a button and create a HCFA (that can be either printed or upload to www.OfficeAlly.com for electronic submittal). In the exam section, the billing codes are created when you finish the Plan & Assessment Tool. At the moment, they do not cross over to the billing module automatically (they may in next version of the software). Also, a simple E&M coding wizard is available in the Plan & Assessment Tool.


Q: Does it generate a daily log sheet or daily report that will break down the day's receipts/ $ totals into various categories i.e. eye exams, Contact lens fits, contact lens supplies sold, visual fields etc? Can this be customized to mimic how we currently reconcile the numbers at the end of the day?

A: The billing module includes a daily totals report. However this is quite basic. In the future, a more advanced reporting feature will be added that allows for breakdowns as you've described.


Q: I can't get insurance payments to post to an account.

A: First, make sure you have selected the appropriate insurance in the patients demographics screen in ezChartWriter. Assuming you have a fee slip with the same insurance selected as the insurance type (and at least some dollar amount indicated as payment due from the insurance company), the patient should have an "Insurance Balance". To indicate that you received a check from the insurance company, click the "Post Payments" button at the bottom of the main screen. You would then select the appropriate insurance company and enter the check amount. A list of patients with balances owed for that insurance company will be displayed. If the insurance company "paid in full", you need to simply click the sixth column's check box (Paid Full). Otherwise, click the small plus sign on the left to display the full charges and enter the actual amounts in column seven (7), labeled "Actual" payment. Use the other checkboxes on the row to indicate write -offs and balance transfers. Note that when you enter an amount paid in the payment line BEFORE you click the small expansion plus-sign button, the software will auto calculate each amount in proportion to the total amount. You would likely have to edit these amounts.


Q: How do I set the charges for the different procedure codes?

A: In the Billing Module, select the menu item at top: Options, then Fees/Products. You can edit them there. You can also add your own codes as needed.


Q: Is there a way to get the amount the patient paid on the CMS ins. form? Maybe I'm not doing it right, but the total and pt pmt is not coming up on the insurance form?

A: I will check into that; it should port over, but there may be a bug somewhere.


Q: Does the insurance part import the diagnosis codes from the EMR? I find that it has to be entered separately in each section - is that right?

A: Unfortunately, no. The billing module was written as an add-on module, so currently the EMR and billing module don't "talk" to each other. That will be fixed in a future version.


Q: In your billing module, do you have the facility to include other forms of state taxes?

A: Not currently.


Q: When will you have the HL7 ready for electronic filing?

A: We offer electronic insurance claim filing via clearinghouse conversion. The ezClaimBiller module includes claim (CMS/HCFA-1500) creation for uploading to a third-party EDI service (we recommend OfficeAlly.com).


Q: Can we bill and send electronic claims to Medicare on your system?

A: Yes, with the ezClaimBiller module you can either print paper claims or generate batch files to be uploaded to your EDI clearinghouse (we use www.OfficeAlly.com, but any that can read text files/print images should work)


Q: How do I post an insurance payment when there is no dollar amount because it went to the deductible?

A: You must enter the transaction manually.  Open the original FeeSlip, then click the Transactions button.  Start a new line and select “Insurance Payment” from the dropdown.


Q: We do have one problem however, the insurance claim form does not line up when printed out. The tutorial says that only minor adjustments should have to be made, but ours is way off.

A: The problem is with the font, not the alignment. On some computers the default system font is not proportional and so all the text is squeezed together. To fix the issue, you must select a different font (also found on the alignment tool). You will have to experiment a bit to find one of the six available fonts that matches one on your computer. I recommend keeping the font size at 12pt though.


Q: Using office ally as an electronic billing solution for ezChartWriter. How do you use that? Do you convert the paper form to electronic?

A: If you are already printing the paper HCFA/CMS-1500 forms, you only need to add a few steps to go electronic. First, you have to sign up with officeally.com or similar EDI clearinghouse. Then, for each claim you create on screen you would click the "Export" button at the top (instead of "Print"). At the end of the day (or week, or whatever schedule you desire), you need to batch and upload the claims. To "batch" your individual claims, you click the UPLOAD button on the billing module main screen. Select all claims to include and press SAVE. Remember where the folder is that you saved to (typically C:\ezHW_Data\Claims\Batch". So you now have a file that the clearinghouse can use. You must upload the claim to the website; you do this by logging into OfficeAlly and clicking the "Upload Claims" menu on the left. You will be directed to locate the batch file. A confirmation screen appears telling you the upload was successful.


Q: When I click on the help button in the Billing Software mode, it opens up the EMR help. There are no instructions on how to use the billing software, and I don't know where to begin with it.

A: I'm sad to say there is not a billing manual ready yet... I've been holding off pending making finalized changes to the module (should be ready late 2009).


Q: How do I go about billing a patient visit?

A: The basic flow of the billing module is to pull a patient chart (called a ledger on the billing side) and create a FeeSlip (analogous to the encounter on the EMR side). You populate the FeeSlip by typing the CPT code and selecting any insurances and/or discounts. From there you can: (1) record a payment with the button on bottom left of FeeSlip, (2) print a billing statement and (3)


Q: How do you prepare and print out a patient Superbill?

A: You can do a paper Superbill by simply printing out from the Reports Manager->Misc->Billing->Superbill Grid which will give you a report you can hand-fill out and give to patient. If you are thinking more of a statement with billing codes, it's quicker to open the Billing Module, open the patient and create a FeeSlip. You can then click the Print Preview button to get a nice formatted statement.


Q: Can you tell me how I go about importing/uploading the CMS 1500 into Office Ally for making the insurance claim?

A: If you are already printing the paper HCFA/CMS-1500 forms, you only need to add a few steps to go electronic. First, you have to sign up with officeally.com or similar EDI clearinghouse. Then, for each claim you create on screen you would click the "Export" button at the top (instead of "Print"). At the end of the day (or week, or whatever schedule you desire), you need to batch and upload the claims. To "batch" your individual claims, you click the UPLOAD button on the billing module main screen. Select all claims to include and press SAVE. Remember where the folder is that you saved to (typically C:\ezHW_Data\Claims\Batch". So you now have a file that the clearinghouse can use. You must upload the claim to the website; you do this by logging into OfficeAlly and clicking the "Upload Claims" menu on the left. You will be directed to located the batch file. A confirmation screen appears telling you the upload was successful.


Q: I still have a very hard time trying bring back the patient's FEE SLIP. Hopefully you able to give some hint?

A: Once you create a FeeSlip, you can find it two ways: (1) if there is an outstanding balance, it will show up on the Accounts Receivables (AR) list on the main page or (2) you enter the patient name (or partial name, such as "Smi,J" to find Joe Smith in the QuickFind box. Once the patient name is displayed in the Pulled Ledgers list, you double-click it to pull up the list of prior FeeSlips and insurance claims. This works very similar to how you pull up patient encounters on the charting side.


Q: How can I give a patient a simple superbill?

A: There are pre-printed SuperBills in the Report Manager that you can use. On the main ezChartWriter screen, open the Encounter List and click the Report icon, then "Add New" then Misc->Billing Reports->SuperBill Grid. This report does NOT save CPT or ICD-9 codes, but is nice if you need a simple record of charges to give patient. You can edit the report to your liking with the Report Designer in the Special Functions menu.


Q: Is the ezClaimBiller capable of uploading to a clearinghouse?  If so, can you recommend one?

A: Yes you can use ezClaimBiller to upload to a clearinghouse. The recommended one is OfficeAlly.com. Instead of clicking "Print" claim, you would select "Export", then save the file. When ready to upload all your claims, just hit the "Upload" button to convert them into a machine-readable batch file. The go to OfficeAlly.com and upload them into their system.


Q: I just had a question about your software for billing ins. Can you input the info into the emr billing section and electronically sent it to the ins co. via the Internet? Or do you have to print out a form and mail it in? I currently am looking at your software and just had some questions.

A: You can send it to the insurance company electronically, but you actually send it to a clearinghouse first. The one we recommend is called www.OfficeAlly.com. It's free to use (the insurance companies pay them) and fairly easy. All you would do is click the Export button instead of the Print button on the HCFA/CMS-1500 form screen. Then when you are ready to send them to OfficeAlly, you click the Upload button to convert to machine-readable format and then go to the OfficeAlly site to upload/send them the file.


Q: To electronically file your billing, do we need to contract thru a clearinghouse or does your company do that for your customers?  Either way do you know how much extra that would cost ?

A: You do need to use a clearinghouse (we don't process claims). Most clearinghouses are paid by the insurance company, so they charge only a nominal fee. We recommend OfficeAlly.com (they are free and charge only for any claims that require paper mailing). As far as our software, the claim generation, batching and uploading is included in your licensing fee of the ezClaimBiller module.