1. Go to Administration > Access Levels.
2. Select the existing access level or create a new access level.
   
   
3. Select the 2nd User Access tab.
4. Under Billing, check the box for Insurance Billing.
5. Click Save and repeat for each access level that will be given permission for Insurance Billing.

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Go to Billing > Insurance Billing.

1. Under Refresh with visits that had, select the type of visits that will be displayed upon refresh.
   • Pre-Edit Errors will display all visits with pre-edit errors.
   • No Pre-Edit Errors will display all visits with no pre-edit errors.
   • All will display all visits whether they have pre-edit errors or not.
2. Clinical Staff Selected will display the number of clinical staff selected for billing.
3. Programs Selected will display the number of programs selected for billing.
4. Facilities Selected will display the number of facilities selected for billing.
5. Check the box for Bill using pre-edit check to process ONLY those claims that do not have pre-edit checks. If not selected, you can process claims with pre-edit errors associated with the claim.
6. Check the box for Test Claim to produce the billing format for those claim(s) selected to review the file prior to actual submission to the payer(s).
7. Check the box for Create Headers to create a test file that will include description headers of the sections of the file format.
8. Check the box for Use Insurance Admin Overrides to billing using the settings selected in Administration > Insurances > Admin Override tab.
9. The Unbilled Claims table will display a list of unbilled claims separated by format.
   
   
    
   • The Code column will display the code of the unbilled claim.
   • The Format column will display the format of the unbilled claim.
   • The Count will display the number of unbilled claims for that format.
   • The Charges will display the accumulated charges of the unbilled claims for that format.
   • The Count With Errors column will display the number of unbilled claims with errors for that format.
   • The Charges With Errors column will display the accumulated charges of unbilled claims with errors for that format.
   • The Count No Errors column will display the number of unbilled claims with no errors for that format.
   • The Charges No Errors column will display the number of accumulated charges of unbilled claims with no errors for that format.
10. In the Select Billing Format table, select the billing format you want to produce the file for submission.
    
    
     
    • The Code column will display the billing code for that format.
    • The Format column will display the billing format.
    • The Type column will display the type of service that will be billed.
    • In the Electronic column, a check next to the form will indicate that the file is in an electronic format.
    • If the format is a “drop to Paper” format (UB-04 / CMS 1500), the Printer column will denote the print format.
11. The Select Insurance Companies table allows the user to select the insurance companies to include in the billing file.
    • Click the Select Charges button to select individual charges to be included in the file for submission from the Charge List.
12. Under Date Range, select a DOS Start and DOS End to filter claims displayed by a Date of Service date range.
13. Under Billing Status processing messages will display, whether running pre-edits, processing claims for submission, or file upload to the clearinghouse.
    • Check the box for Pre-Edit Report to view the Pre-edit Report.
      • This is only available after the Pre-Edit is run.
    • Check the box for Billing Report to view the Billing Report.
      • This is only available after the Pre-edit Report is run, returns no errors, and Process is run.

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1. The Clinical Staff column allows the user to choose which Clinical Staff will be included in billing.
2. The Programs column allows the user to choose which Programs will be included in billing.
3. The Facility column allows the user to choose which Facilities will be included in billing.

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1. Click Refresh to remove any items that have been selected, and return the screen to the original window.
2. Click Adjust to adjust the printer display.
3. Click Pre-Edit to run the Pre-Edit examination on selected claims.
4. Click Process to create the file for the claims selected in Insurance Billing, and if using the clearinghouse integrated solution, will transmit the file to the clearinghouse for submission.
5. Click Get Ability Responses to open a window to import and download file responses from the clearinghouse and payer, to display in the Response Reader.
6. If a file failed to transmit to the clearinghouse successfully, click Retry Sending Ability Files to queue up the failed file to resubmit.

Additional settings for Insurance Billing can be found in Clinic Options.
 

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