Billing Process

Steps of the billing process will take place throughout the month so that the day billing is processed things should move along efficiently.  We will step through the billing process pointing out items that can be done daily/weekly to streamline your billing process. 

Enter charges Manually:

Entering charges manually can take place anytime through the month prior to posting charges.  The process of "Populating invoices" does not impact manual charges at all because they are directly entered on the resident's charge screen.

Check for Missing Recap:

It is vital that each facility be vigilant in monitoring "Missing recap".  Missing recap are services and/or medications that have not been marked done OR skipped/declined.  There is never a reason to leave a service "undocumented" so it turns into a "missing recap".  This is not only important for billing purposes but also for state audits in compliance of care plans.  Our Login report "Missing Services/Chores - 72 hours" should be viewed and missing recap corrected DAILY.

Testing before Billing:

Before you process invoices, you want to ensure resident information is entered completely, including Care packages, rent rates,and in some cases, admission numbers.  When you start billing we recommend running the report "Test before billing".  To do that:

  • Click on Billing - Begin (Month) Billing
  • View Reports and select Test Before Billing
  • Click Create report

  • If any resident is missing a care package, Set the care package before populating invoices or change their billing option to Fee for Service
  • If any resident has an invalid or missing rent you would want to Select the rent before populating invoices
  • If a resident is missing an admission number - From the Resident option - select a resident - click Update profile and add the admission number
  • Once the "Test Before Billing" report displays "No issues found" you are ready to continue the billing process

Populate Invoices:

Populating invoices is the step in the billing process where all the charges come together.  This process will gather all the fees (care package, rent, supplemental packages, incremental service fees and contract amounts) and create invoice lines as applicable for each resident. To do this:

  • Click on Billing - Begin (month) Billing
  • Click Populate Invoices (month)

  • The charges will display in the "Total" column for each resident

Reviewing Invoices:

During the review process you will review for possible adjustments and review the trial invoices. 

Review for Possible Adjustments:

When reviewing for possible adjustments you will determine if any credits need to be made or additional charges need to added for people who moved in, moved out or went on hold.  You can also see who added/changed care packages and/or supplemental packages. To run this report:

  • After the invoice lines are populated - click View reports
  • Select "Review for Possible Adjustments"
  • Click Create report

Trial Invoice Detail:

The "Trial Invoice Detail" report will allow you to see a consolidated view of all of your residents with every charge for that billing period.  This report should be analyzed closely by both the billing team AND clinical team to verify accuracy. To run the report:

  • After the invoice lines are populated - click View reports
  • Select "Trial Invoice Detail"
  • Click Create report

  • Scroll through the report reviewing all of the charges
  • Each resident will have the payer(s) displayed and all the charges associated with that payer
  • Each payer has a total 
  • The resident will get invoiced ONLY charges under the "Private" payer section

Editing Charges:

When reviewing the Trial Invoice Detail report or the Review for Possible Adjustments you may find the need to edit or delete charges

To Edit Charges:

  • Click on Billing and then the Charges option
  • Click on any charge and edit  the charge as needed
  • Press Save Charge when finished

To Delete Charges:

  • Click on Billing and then the Charges option
  • The "Trash can" by any charge line
  • Press Confirm and the charge will be deleted

NOTE: If you edit or delete charges and Unpopulate charges and then Populate charges - the changes you made will be lost.

Posting Invoices:

  • When you are finished reviewing and making changes - click the Post Invoices (month) button