Billing and Claims Submission

A billing module designed to make sure that all your bills get paid on time. Special features to support the unique issues presented in invoicing for services provided by these Long Term Care providers:

• Skilled Nursing Facilities (SNFs)
• Adult Day Care Providers (ADCs)
• Life Plan Communities (Continuing Care Retirement Communities (CCRCs))
• State Veterans Homes (SVHs)

Integrated Census Control
Easily manage invoice adjustments with an integrated ADT census that automatically updates billing records and provides detailed summaries that can be used to verify that all resident days are included in an invoice.

Ancillary services
Are the support services including room, board, medical and nursing services that are provided to patients/residents in the course of care at the facility or prgoram. They include such services as laboratory, medical supplies, radiology, pharmacy, physical therapy and rehabilitation services. The Billing/Claims system collects all the Ancillary charges that have been generated by the Services to the patient and will include them on the proper Claim submissions.

Managing Multiple Payors
Review and correct bills before committing them to history and then bill all paysources at one time without having to process separate runs for each invoice type.

Medicaid & Medicare Billing
Complies with all State Medicaid billing requirements, including rules for bed retentions (BR) and leaves of absence (LOA). Also, provides alerts when a resident approaches the LOA and Bed Retention benefit limits.

Coordination of Benefits
Manage deductibles and co-insurance, then automatically invoice secondary third party paysources for services not covered by a resident’s primary insurers.

• Accelerated Cash Flow
• Collect Overdue Invoices
• Consolidated Billing (CB)
• Faster Billing/ Collections
• Multiple Billings per Cycle

• BNI Notices/FFS SNF
• Census Driven Invoicing
• Coordination of Benefits
• Charge Paysource Calculated
• Electronic Invoices/Remittances
• In-Patient Rehabilitation
• On-Demand Billing
• Rebilling
• SNF Medicare Part A, B, & D
• Vendor Charge Import

• ADT/Census
• Ancillary Charges
• Claims Management
• Clearinghouses
• Diagnostic Index
• MDS/PDPM Scores
• Resident Trust Funds
• Vendor Service Providers