Embedded Files
Requirements: All agency biller or any Hospice Centre account holding agency personnel who has access and authority to do billing task can gain entry to this section. All visits should be posted for the month before processing the claim.
The Batch Billing page is located under the Batch menu of Hospice Centre.
1.pngThe Batch Billing page has three tree nodes on the left: the Batch Billing Process, Claims Reconciliation, and Olympus Services.
Please note that Olympus/Ability Services is only applicable to those agencies that have Olympus/Ability with DSL.
2.pngPROCESSING A CLAIM
PROCESSING A CLAIM
To process a claim, there are four easy steps: Draft Claim, Batch Claims, Export Claims, and Submitted Claims.
2.1.pngStep 1: Draft Claim
Step 1: Draft Claim
There are different filters to draft a claim: Insurance, Bill type, Billing Month & Year (hospice process claims per month), NOE (optional), Patient (optional).
3.png4.pngIn Hospice, there are different bill types that the user can generate:
81A NOE Bill (Notice of Election) - This is not a claim but a time-sensitive bill that the user needs to process within five days upon admission of the patient. This will show in the standard working file of Medicare that the patient is under the agency.
81B NOTR Bill (Notice of Termination/Revocation) – The user can process this bill once the patient opted to terminate/revoke the services from hospice.
81C Change Hospice – The user can process this bill if the patient has been transferred from the agency’s hospice to another agency.
811 Admit through Discharge – The user can process this bill if the patient was admitted then discharged from hospice within the same month.
812 Interim First Claim - This is the claim during the first month of the patient in hospice.
813 Interim Continuing Claim - This is the claim for the following months of the patient in hospice.
814 Interim Last Claim - This is the claim for the last month of the patient in hospice. After the user filtered the information, click the “Search/Refresh” button.
5.pngOnce the list of names populates on the screen, the first thing that the user needs to check is the status of the claim. It will serve as a validation report for the claim.
Select the “Print” button to unbilled print-out claims with validation.
6.pngStatuses
Error - There are documents (required for generating a claim) that need to be completed.
Warning - There are documents (optional) that need to be completed.
Successful - All documents are completed. Claims are ready to be generated.
7.pngPut a check mark on the claim that needs to be generated, then click “Generate Claim.”
Step 2: Batch Claims
Step 2: Batch Claims
On this page, the user will have the option to preview the UB04.
The UB04 Update feature is available if the biller of the agency needs to edit items in the UB04.
8.png9.pngOnce done reviewing the UB04, the user will have the option to either perform one of these actions:
Undraft - This will remove the claim from step 2, and it will go back to step 1 Draft Claim.
Batch Claim - This will move the claim from step 2 and then step 3.
To batch a claim, select the claim(s) to be included in the batch then click “Batch Claim” button. Enter the Batch Name, select the Batch Type, then click “Generate Batch.” The claim will move to step 3 Export Claims.
Save Changes - if the user performs one of the actions, then they must save any changes to the page.
10.png11.pngStep 3: Export Claims
Step 3: Export Claims
12.pngSelect the batch to be submitted to Ability. If the agency has Ability / Olympus Services with DSL, click “Submit.” Otherwise, select “Mark as Submitted.” Choose the method of submission, then click “Proceed.”
On this page, the 837 Download feature is available. This allows the user to download the 837 files of the claim used in the electronic submission.
13.pngStep 4: Submitted Claims
Step 4: Submitted Claims
This is where the user can see all the batch files that were submitted. On the uppermost of the page, the user can filter the information by batch or billing period.
In this page, the user can flag the batch as Accepted or Rejected under the Batch Status column. If a batch claim is rejected for some reason, the user needs to select the claim and click the “Unbatch.” It will move back to step 2.
15.pngHow to know if a claim was accepted or rejected?
How to know if a claim was accepted or rejected?
If the agency has an Ability / Olympus with DSL, the responses from Medicare will show in the Batch Receive Files page.
15.1.pngIf the agency has an Ability / Olympus with DSL, the responses from Medicare will show in the Batch Receive Files page.
The TRN responses include Acknowledgement (999), Claims Acknowledgment (277), and Payment Advice (835).
To view the contents, click “View” on the right of the file.
Mark as Read - Use this to mark the TRN file as read.
Mark as Unread - Use this to mark the TRN file as unread.
Import Electronic Remittance Advice - The users can import ERA or pull up Ability Files.
Reconcile - Users can reconcile the claim in the Payment Advice (835).
16.pngCLAIMS RECONCILIATION
CLAIMS RECONCILIATION
This is the page where users can reconcile the claims. Users need to import the Electronic Remittance Advice file from Ability or pull-up the file from Batch Receive Files page.
To pull up the pull-up the Remittance Advice file from Batch Receive Files page, click the “ERA files” on the upper right (applicable only for agencies that have Olympus / Ability service with DSL).
17.pngTo import a file, users need to click the “Import Electronic Remittance Advice (ERA).” Once the user imports the record, the information of the claim will auto-populate to the respective boxes, and then users need to click “Reconcile.”
18.pngOnce the claim is reconciled, it will reflect under the Patient’s Billing Ledger under the Patient Chart.
Under the Bills tab, the user will have the option to View Details of the claim or preview the UB04.
19.pngClicking the View Details link will show the Ledger, Line Items, and Logs.
20.png21.png22.pngUnder the Account Balance tab, the Ledger will show up. The user can manually add a new entry to the ledger by clicking the “Add” button.
23.pngVersion Control #: DSL2019-2.2
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