HOW TO BILL
To open the Billing area,
choose Billing (Carrier & Patient).
Or click on the [B] on the
tool bar .
You will use this section
of TPS2000 to create HCFA (and other carrier billing forms) to bill your Carriers and Patient Statements
to send to your patients.
ADD A NEW CARRIER BILL BATCH
To start a new bill run,
click on the [+] icon on your Navigation Bar.
You will see the message “Do you want to start a new bill run?”. If you answer YES it will create a blank
screen ready for you to enter data.
Under Bill Type – choose the type of bill batch
Following are the types
of bills we can produce:
REGULAR BILL - Used for normal Carrier bills and Patient
Statements
You may, at any time,
reprint an existing bill in the TPS 2000 program. It doesn't matter if this bill is completely
unpaid, partially paid or entirely paid.
It is possible to reprint it from the original batch. However, it may not be convenient or efficient
to reprint original bills under some circumstances, TPS 2000 has the ability to
automatically track and then create on demand Tracers and Rebills
AUTO-REBILL - This
is the process of automatically generating new bills for services which were
previously billed to the carrier and not fully paid by the carrier. (Fully paid is based on the carrier portion
of the service as compared with the amount paid against that carrier's
portion). If the patient has paid his
portion, this will not effect the rebill process. REMEMBER the full amount of the service will
be billed even if a partial payment has been received.
TRACER -
These bills deal with entire bills that have been previously generated that are
completely unpaid. (Completely unpaid is
based on the carrier portion of the services contained on the bill as compared
with the amount paid against that carrier's portion). If the patient has paid his portion, this
will not effect the tracer process.
MANUAL-REBILL - This is the process of manually generating new
bills for services which were previously billed to the carrier and not fully
paid by the carrier. (Fully paid is
based on the carrier portion of the service as compared with the amount paid
against that carrier's portion). If the
patient has paid his portion, this will not effect the rebill process. REMEMBER the full amount of the service will
be billed even if a partial payment has been received.
The next selection is Bill To –
You have two choices for this entry:
PATIENT STATEMENTS – If you select this entry, it will create
patient statements for all or some of your patients. The Patient Statements in TPS 2000 work
similarly to your credit card statements.
They will show all activity that has happened in the patient’s account
since the last time you processed a statement for this patient.
CARRIER AND ATTORNEY BILLS -- if
you select this entry, it will create carrier and/or attorney bills in the
format setup in the carrier and/or attorney entries.
The Level – field is used for Carrier/Attorney
statements. If this is a first bill
(first time these services have been billed to a carrier), then this will be a
PRIMARY bill batch.
PRIMARY - Primary means first. This usually refers to the insurance company
that directly insures your patient. For Example, Mrs. Brown has
SECONDARY - Secondary means second. This usually refers to backup or additional
insurance for your patient. For Example,
Mrs. Brown has
NOTE: A primary
bill must have been created and posted before services will be eligible to be
processed as a secondary bill run.
TERTIARY - Tertiary means third. This seems to be seldom used. There would be a couple of common scenarios: First -
Bob Brown is a 17 year old box boy at the local grocery store. He is covered by Retail Clerks insurance through
his work and this is his primary. Bob is
also covered by his Father’s Blue Cross Insurance, this would be Bob’s
Secondary. In addition, Bob is covered
by his mother’s Aetna policy, this would be his Tertiary coverage. Second – Your patient has an automobile
accident. This patient is covered by a
MedPay policy, this would be the primary.
This patient also has medical insurance through their work, this would
be the secondary. Finally, your patient
was not the party at fault, so the Tertiary coverage would be the at fault
person’s insurance.
NOTE: A primary
and a secondary bill must have been created and posted before services will be
eligible to be processed as a tertiary bill run.
Bill Date will default to Today’s Date, this may be
changed if you wish, by clicking on the small calendar to the right of the date
entry.
Minimum Bill Amount – This is the smallest amount due for
which a Carrier Bill will be processed.
NOTE: Do not make this amount
greater than the smallest services and/or inventory item provided. I.e. if you sell an ice pack for $3.00, do
not make the minimum bill due greater than $3.00 or there is a chance that this
item may never be billed.
Maximum Bill Amount – This is the largest amount that you
want to see on a bill run for an individual patient. There are some states, or even specific
insurance companies that don’t want to see a bill larger than $300.00. Anything over this amount goes to a supervisor
and may delay your payment. TPS 2000
allows you to control how much is billed in a single bill run.
End Date -- This date defaults to yesterday’s date,
however, it may be changed if you wish, by clicking on the small calendar to
the right of the date entry.
Once you have filled in the above settings click on
CREATE BILLS…
You will now be on the screen to select the providers for
whom you are billing. You may select
individual providers (or hold down the CTRL key and click on more than one
provider), or place a check mark in the Select All box to create bills for all
providers in the system.
Next, decide if you will be billing ALL CARRIERS,
SELECTED CARRIERS, CARRIERS BY TYPE or only certain patients FOR SELECTED CARRIERS.
CARRIER BY TYPE
Click on the Select Carrier by Type Tab. Choose the carrier type(s) for whom you are
processing bills. This should ONLY be
used to bill a specific type of carrier.
This is not the selection to use if you wish to bill ALL
carriers. The All on this screen will
select all carriers that have been typed.
If you have a carrier that does not have a type (i.e. WC, PI, etc.)
setup, this carrier will not be in this bill batch.
ALL OR SELECTED CARRIERS
Click on the Select Carrier Tab. Choose ALL or the individual carriers for
whom you are processing bills.
If you wish to create bills for anything that is eligible
to be billed, place a checkmark in the Select All box then click on [Create
Bills].
PATIENTS FOR SELECTED CARRIERS
Click on the Select Carrier Tab. Choose the individual carriers for whom you
are processing bills. Then click on
Select Patients Tab. This will display a
list of patients that have the carrier(s) you selected in their file. Click on ALL or the individual patients for
whom you are processing bills.
At the bottom of your screen is a button titled CREATE
BILLS. Click on this button when you
have made the above selections.
Once the bills display the column on the left is the
PRINT selector. If there is an arrow in
this column the bill is set to print.
You may control which bills print (including all) by clicking on the
individual bills or using the Print Selection buttons at the bottom of the
screen.
Print Selections
All – Click
this button to place a checkmark in the Print column of All bills on this
screen.
None –
Uncheck the print column of All bills on this screen.
Expected >$0 – Used
ONLY in the printing of Patient Statements.
This key will tag for
printing ONLY those bills whose
expected column shows a value greater than $0.00.
Tag EB –
Click this button to place a checkmark in the print column of any bill whose
form
is designated as electronic
(i.e. E-Claims Electronic Billing Format, 837 Health Care
Claim Professional, etc.).
No EB - Click this button to remove the checkmark from
the print column of any bill
whose form is designated as
electronic (i.e. E-Claims Electronic Billing Format, 837
Health Care Claim Professional,
etc.).
Print Setups
View – Click
this button to view the data entries (spreadsheet format) of the selected
bills.
Align – Click
this button to align the layout of one of the paper formats (i.e. HCFA General
Red 1.7) to your printer. (NOTE:
See “HCFA Alignments” in the Trouble
Shooting Section for more
information on this button.
Edit Layout – Click
this button to edit the layout of one of the paper formats (i.e. HCFA
General Red 1.7). You may move individual fields for more
specific alignment or
change a formula if needed.
Printing Activities
Bill Summary – Click
this button to print a summary of this bill batch.
Preview Bill – Click this button to see a screen preview of
the bill.
Labels – If you need to print labels for mailing,
place a checkmark in the print column for
each carrier (or patient if this is a patient
statement batch) needed. Then click this
button.
Print Bills –
Click this button to print all bills that have a check mark in the Print
Column.
SOAP - If
you need to print SOAP notes, place a checkmark in the print column for
each patient needed. Then click this button.
HIPAA Electronic Billing
Export – Click
this button to export your 837 Health Care Claim Professional claims ready
for transmission to your
clearing house, billing service, or directly to the carrier.
Import – Click this button to import your status update
for any 837 Health Care Claim
Professional batches that have
been previously submitted.
History – Click this button to view the history of any
837 Health Care Claim Professional
bills.
TO FIND A PAST BILL BATCH
To find a past bill batch, you may either “step”
backwards by using the VCR arrows on the tool bar. The single arrow to the left will step you
back one batch at a time. Or the double
arrow to the left will take you to the very first bill batch you created.
You may also click on the button to the far right of the
VCR arrows (looks a little like a spreadsheet).
This will display a list of all entries in the open table. You may then find the batch you desire
(either by batch number or by date) and double click on it to bring it up.
TO DELETE AN INDIVIDUAL
BILL FROM A BATCH
Should you need to remove a single bill from a batch, do
the following. In the print options at
the bottom of the screen, click ALL to tag all bills ready to print. Now untag the one that you wish to remove. When you have untagged the bill(s) you wish
to remove from this batch, click on [Delete Bills].