This article discusses the use of the billing manager. To review how billing works within an application, click here.
This feature requires administrator access.
General Layout
- Billing Sets - a billing set is...
Billing Set
The general construct of a billing set is:
- An app can have one or more billing sets
- A billing set can have one or more procedures
- A procedure can have one or more procedure codes (CPT/HCPCS/CDM). Procedures exist directly in the billing set and are assigned to procedures but can also exist outside of a procedure
- A procedure code can have one or more associated ICD diagnostic codes via a crosswalk. Diagnosis codes exist directly in the billing set, are accessible from the entire ICD-CM code set and can also exist outside of a crosswalk.
Creating a new billing set
Exporting and importing billing sets
Collapse and expand
Right click functions
Show Hidden
Billing Set Maintenance
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The Billing Set Definition
Adding a new biling procedure or category
Choose a billing procedure to edit its set
Show or hide biling sets
The concept of a crosswalk
Procedure codes for chosen procedure
Build by dragging up from All procedure codes
Edit existing
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Default selections
Right click to edit and add modifiers
All procedure codes in this billing set
Use of this section:
- Build procedure code list for this billing set.
- Drag upward to include procedure code in specific defined procedure
- This becomes a list the user can choose from to add non-standard procedure codes.
Diagnostic codes
Adding a new code
Associating a diagnostic code with a procedure
Diagnostic codes for the CE
Uses of all codes in CE and linked list
Assignment
General definition of assignment
How to choose the billing set to use for a specific lab/location
Disabling billing
The red badge and its meaning
Order Map Manager
This feature allows an order to choose a billing procedure automatically based on the order content. (details)
To use this feature, a set of all orders must be received into EncaptureMD through the HL7 billing interface. A billing set for the specific app must be installed.
Whoever performs this action must understand clinical orders and how they relate to billing.
Applications
Orders are received via HL7 from an electronic record system or PACS. Initially all orders are unmapped and appear in the list on the right. Orders are mapped to specific applications. Some orders will never be used and can be ignored...
Assigning billing procedures
Unmapping right click
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Facilities
A facility is...
Why facilities matter
Mapping and un-mapping for a specific (not sure but DALA?)
Modifier Codes
Definition (high level)
import/export
Add, edit and (right click)delete
Tech pro or both
Changing the order
Global Billing Codes
Procedure codes left diagnostic codes right
Procedure Codes
Add new
Import export
Show active
Right click function
Diagnostic Codes
Describe similarly to Procedure codes
