Billing Automation - Invoice Processing

When enabled, all future Invoices that have not been added to Claims Awaiting Submission will be automatically added to Claims Awaiting Submission. To exclude Invoices from automatic processing, exclusion rules can be configured on the Automation Settings page.

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Enable Automated Invoice Processing

1. Click Claims Service under Organization.
2. Click Automation Settings tab.
   
    
3. Click the toggle to Enable Automated Invoice Processing. A confirmation window opens.
   
    
4. Click Enable in the confirmation window. The toggle moves to the right and turns blue.
    
   
    
5. The Exclusion window opens where you can configure conditions to exclude invoices from automatic processing.

   NOTE: A default exclusion rule will be populated to prevent self-pay invoices from being added to claims awaiting submission.

   
    

   
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Set Exclusion Rules

You can exclude invoices from automatic processing by configuring exclusion rules.

1. The Exclusion Rules window opens when you enable the setting.
2. Select conditions in the dropdowns for fields: When (condition) Equals (condition). 
3. Click +Add Condition to add as many conditions as needed.
4. Click +Add Rule to add as many rules as needed.
5. Click Save for each rule.
   
   
    

The following When conditions are available for configuring Invoice Processing Exclusion Rules: 

• Client pays by 
• Rendering Provider
• Service Type
• Primary Insurer
• Claim Level
• Invoice Date
• Invoice Date range
• Progress Note signed by provider
   

  NOTE: If the supervisee has a supervisor who needs to approve, the progress note is considered signed when the supervisee has signed the note.
  If the supervisee has a supervisor who needs to cosign, the progress note is considered signed when both the supervisee and supervisor have signed the note.

  
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Disable Automated Invoice Processing

1. Click the toggle setting.
    
    
2. A message displays to confirm the setting is disabled.
    
    

   NOTE: A Disable button also displays in the confirmation window when you enable a setting but it is only used to cancel the Enable action.
    
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Suggested Use Cases

Rendering Provider and Primary Insurer

Use Case - If your Organization would like to prevent automated processing of Invoices to Claims Awaiting Submission that have a specific Rendering Provider and a set of Primary Insurers, the following is an example of the exclusion rule that should be configured:
 

Service Types

Use Case - If your Organization would like to prevent automated processing of Invoices to Claims Awaiting Submission that have a specific set of Service Types, the following is an example of the exclusion rule that should be configured: 
 

Specific Rendering Provider without a signed Progress Note

If your Organization would like to prevent automated processing of Invoices to Claims Awaiting Submission that have a specific Rendering Provider and without a Progress Note signed, the following is an example of the exclusion rule that should be configured: 


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