This article covers how to use the billing tab within an application. This example uses the Echo application, but these instructions apply to all applications. The invasive apps have more complex billing, but the process is very similar.
For configuration of the billing tab by an Admin, click here.
If the billing tab is not visible for a user, it may be because
- The user does not have biling privileges
- Billing is not active for this app for this customer
- Billing is active, but not set up properly.
If you think you should be able to see the billing tab, please ask your administrator for help.
General layout
- Selected Procedures - more than one procedure can be chosen.
- Procedures are groups of procedure codes
- List of procedure codes for the selected procedure
- List of all procedure codes in this app
- Diagnostic code list
- The constructed pro and tech bills
Choose Procedures
Procedure Codes for:
Application Procedure Codes
The Application Procedure Codes list shows all procedure codes associated with this procedure. If you need to choose a code that is not typically associated with the procedure, search for it by code or description and check the box in the first column to add it to this study. Procedure codes can have internal/CDM codes, quantities, comments and RVU's used for proper association to EMR billing
Relevant ICD codes linked to a CPT code
After choosing the procedure, click on a row in the Procedure Codes For table. This will show the diagnosis codes that are usable to justify the selected procedure. This crosswalk is specific to the row chosen. Different rows may have different diagnostic codes.
Billing Report
- Current Prof - this is the professional bill which will show the procedure(s), the procedure code(s) and the diagnostic code(s). You can also see text that says that 93312 maps to A41.84 and I48.0.
- A procedure code must have an associated diagnostic code and the code chosen satisfies that requirement.
- A CPT code may not have an associated ICD codes so N/A will be displayed.
- A red warning will indicate a needed match
- Final Prof - once signed, this tab will show the final professional bill
- Current Tech - may show the same CPT codes as the Prof bill, but may bill on time. Will also include inventory.
- Final Tech - the final tech bill is the signed bill.
- Blue procedure code links - edit the procedure/add or remove modifier
- Blue diagnostic code links -
- (x) to remove
- (Primary) listed top of list. Click Set as Primary to promote that row to primary.
Validation
Billing/Coding validation shows a $ in the red or yellow square. The validation shows
- which codes can be used together
- whether there is a proper ICD code for each procedure code
- whether the content of the report contains the correct text to justify the codes chosen OR whether the report text justifies codes that have not been chosen.
Permissions and App-specific configuration
Bill signing can be configured in different ways
- MD sign separately v sign with clinical report. If the bill is to be signed separately, the Current Prof screen above will have either a Sign or Sign and Submit button.
- Sign will finalize the bill but it will not be sent to the EMR. A second user must submit. This can be a tech or it can be a coder working in EncaptureMD.