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Billing Update - Billing run to mark services billed
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Creating Billing run only to mark services as billed
After the remittance talk last week, a number of people inquired about how to handle Medicare forwards claims (When Medicare automatically forwards claims to the next payer). Here are detailed instructions:
1. Billing Header: The secondary payer must be setup in IMA and be included in the client's billing order.
2. Preliminary Remittance: Review the preliminary batch to find information about all forwarded claims (It is listed directly below the payment information line). You will see insurance plan information (an example would be "UNITEDHEALTHCARE/00082") and an indication if this has been mapped to an IMA insurance plan code. For all plans not already mapped, the plan definition needs to be updated with the forwarding information.
3. Insurance Plan Definition: On the bottom of the billing tab there is a field labeled "Forwarding information". Paste the insurance information listed in the Medicare remit here. This needs to be done for each plan referenced in the remittance
4. Recheck Preliminary Remittance: Check the remittance again. You should see no more, "No translation" messages. I you do, that means some plans have not yet been edited with the forwarding information. Once there are no more missing translations, the remittance can be posted.
5. Create dummy forwarding only service billing batch by:
a. Create billing run up to today or last day of remit payments b. Include all clients c. Check on bottom Forwarded bills only (critical step, don't forget) d. Create batch e. Generate bills (this will mark all secondary as billed) Notes: 1. Reports: If you care to see what services have been forwarding in this manner run the report Remittance Forwarded claims found in Finance/Utilities 2. For OMH and OASAS programs, claims are not really forwarded to Medicaid even if so indicated in the billing batch. This process is NOT needed for these Medicaid claims.
If you want a version of these instructions with screenshots or if you have any questions contact me at lance@imasys.com
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