Billing Best Practices Guide

Follow these billing best practices to assist you in mastering the billing and collections process.

Jump to Section: [Request New Services] [Monitor Claim Remits] [Maintain Accurate Subscriber and Insurance Information] [Run Reports]

 

Request New Services

• Submit a Zendesk ticket to [e-mail] to get a copy of the Billing Information Sheet.
• Complete the AccuPoint Billing Information Sheet to request new services.

• This sheet ensures that AccuPoint communicates the required information to properly bill the services. You can update existing services independently with the Service Line Adjustment transaction tool under the Dashboard. 

  NOTE: You cannot update service names after the service has been created.

Monitor Claim Remits

• Monitor remittances in the payer portal or MDOL website. Please ensure that the claims are being paid and paid correctly. Communicate system set-up issues to the AccuPoint team immediately via the ticket system.
• Set up ERAs (electronic remittance advice) whenever possible in the MDOL portal. AccuPoint can assist with this setup.
• If needed, follow up with the payer to retrieve claim status. AccuPoint does not aide in this process unless you are signed up for our RCM services. 
  

Maintain Accurate Subscriber and Insurance Information

• Enter information in the Client Edit Information transaction page under the Dashboard.
  

  NOTE: Double-check that the information is complete and correct before saving the data so it will upload correctly in the InsuranceNumbers link.

• When a client's insurance changes, you will need to add their new insurance into the system under InsuranceNumbers.
  

  NOTE: InsuranceNumbers is where the system takes the insurance information and puts it into the claim to be billed. 

• Correct inaccurate insurance information in the InsuranceNumbers link. All key demographic information is needed for billing - name, birthday, gender, address, etc.

Run reports

The following reports should be generated to ensure that there are no items “stuck” in the AccuPoint system after a billing batch is generated. All of the below reports, date filters, and service filters can also be used in order to better streamline the results that you are looking for.

Billing and Submission Report

• Ready to Bill drop-down - select Yes
• Billing Status box - select Pending
• Select Update View
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• • • • Items in this status may be missing key demographic information in the Client Edit Information transaction profile or in the client’s InsuranceNumbers. Missing required information restricts the system from submitting service lines.
      • Review and update any missing or invalid client or subscriber information under
      • InsuranceNumbers.
        
        

Under Billing and Submission Report

• Ready to Bill drop-down - select Yes 
• Billing Status box _ Pending
•  

• Check Display Errors to view messages that might explain why a claim was not transmitted. Research and resolve the errors and then resubmit claims.
  
  
  
  
  • •  
  • • • A common error is an incorrect entry in the InsuranceNumbers list.
      • Once the error is resolved based on the information provided in the 'Error Information' column, you will then set the line item to 'Pending' and check the 'Ready to Bill' box so the claim will go out with the next billing batch.

Under Billing and Submission Report

• Ready to Bill drop-down - select No
• Billing Status box - select Pending

• • • • This report pulls up items pending approval.Review and resolve these items regularly to avoid timely filing limits.
      • When line items are reviewed and ready to bill, check the Ready To Bill check box.
      • Scroll to the bottom of the page and select Mark as Ready to Bill.

Under Billing and Submission Report

• Ready to Bill drop-down - select All
• Billing Status box - select  Hour Change Next Bill

• • • • This report displays items billed and the number of units that were revised by editing the associated calendar item.
      • Rebill these items as a frequency 7 type claim – void and replacement. Mark each item as ready to bill by following the steps above.

        NOTE: You cannot send these 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, track the claim to ensure it is accepted as certain payers do not handle the electronic adjustment of claims.

Under Billing and Submission Report

• Ready to Bill drop-down - select All
• Billing Status box - select Billed and Billed Secondary

• • • • Run this report regularly to identify claims that haven't been paid yet or that have not received a payer response.
      • To refine the report, you can use the date filters and the 'Filter By:' dropdown items.
        
        
      • You need to be able to receive electronic remittance files from the payers or post the paper remittances into AccuPoint in a timely manner for this report to be accurate.
      • Investigate items on this report and determine why payment has not yet been received.
  •  
• If an item needs to be resubmitted, change it back to Pending and mark Ready To Bill so it will be submitted with your next billing batch.
  

MDOL Portal

• Review the MDOL portal for rejections at least twice per week. 
  • You can search MDOL with Session Results, payer name, patient first and/or last name, and Transmission Report.
  • Resolve claims marked as rejected in AccuPoint and resubmit them by marking the claims as Pending and Ready To Bill.
  • Items in Audit status:
    
    • Click the Calendar Filter link on the left-hand side of your site's home screen.
      
      
      

• • • Select Audit for the Status Filter drop-down to display items that need additional review because of permission levels or compliance issues.
      

• • • • Permission Levels - the person completing the shift needs to have Director level permissions under User Management.
      • Compliance Issues - check the Compliance Report: Individual from the dashboard for the client in question to view what is missing. Once the compliance issue is fixed, you will need to complete the calendar item. Once this is done, the shift should no longer be in the Audit status.

• • Items in Entered status:
    • Click the Calendar Filter link on the left-hand side of your site's home screen.
    • Select Entered for the Status Filter drop-down to display shifts that were scheduled but never completed.
    • This is the default status that calendar items are put in when created.
      

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