PDGM BILLING

PDGM Billing Page can be accessed by hovering the mouse to “Batch Tools” on the menu bar and clicking on “Batch Billing PDGM.”

Once clicked, it will direct the user to the PDGM Billing Process page.

HOW TO GENERATE PDGM CLAIMS?

Step 1: Draft Claims

Select the right type of claim to be generated, either All Medicare RAPs or All Medicare Final Claims. Select the correct “Summary / Period,” either First 30 Days or Second 30 Days, then click “Search.”

The list of claims will show up at the bottom as search results. 

Select the claim/s to be generated and click “Generate.”

Step 2: Batch Claims

To batch the generated claims, select the type of claim, either “All Medicare RAPs or All Medicare Final Claims,” then click “Search.”

The generated claims will show up. Select the claim/s to be included on the batch and click “Batch Claims.”

Step 3: Submit Claims

Select the batch that needs to be submitted, and click “Submit Electronically” (If the agency has Ability/Olympus Cloud). Otherwise, click “Move to Step 4”. 

Step 4: Submitted Batches

This is where the user can view the submitted batches with the batch status.