Introduction to Billing

Introduction to Billing
 

The system now supports the ability to generate and submit Insurance Claims directly to multiple clearinghouse partners, as well as the ability to generate Invoices and Patient Statements for non-insurance payers. If using a supported clearinghouse partner, ERA's and associated payment info can post directly inside the system via our Payments Ledger. Payments can also be posted manually and support the ability to add adjustments and transfer balances to secondary insurances and/or patient responsibility.

Getting Started

Contact Support at 1-877-796-9883 or codemetro.support@ensorahealth.com to enable the Billing feature. The ability to generate and post payments to non-insurance funding sources can be enabled immediately and training, if desired, scheduled.

If you also bill private insurance, you will need to select a support clearinghouse, OfficeAlly or Apex. When contacting our Support Team to enable the billing feature, please indicate which clearinghouse you will be using in combination with our Billing tools. If you opt for OfficeAlly, you will need to enroll your payers with them to allow ERA's to be sent.

When the Billing feature is enabled, the system will automatically populate the Master Funding Source list for each unique funding source. Please ensure all Payers you plan to submit claims to has the correct Payer ID entered and the correct Network Type selected (Commercial vs. Medicaid). Consult with your partnered clearinghouse's Payer Lists to determine what the ID should be.

During initial set up for insurance funding sources, the system will:

1. Default the Network field to Commercial.
2. Where possible, take the Payer ID from the agency’s funding source record and assign it to the master payer ID.
   • The Payer ID column will indicate whether they are for Office Ally or Apex.
   • If the practice is in the process of migrating from Office Ally to Apex (or vice-versa), both clearinghouse payer IDs will be displayed in separate columns.
3. It may not be possible for the system to assign every insurance payer ID, in which case, the field will be left blank.

After the Billing feature is enabled, any new funding sources will need to be added in the Master Funding Source first, then created in any agency that will use that funding source.  Any updates to a payer ID will be maintained in the master funding source record, and the ID will be shown as view-only on the mapped funding source record.