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Rebilling

Rebilling. 2012 Annual Conference. ADL DATA SYSTEMS, INC. Rebilling Functions. Process Rebilling Records Edit Rebilling Records Delete Claims from Electronic file Print & Edit UB04 Copy History file to Rebilling Copy Current file to Rebilling Using Rebilling for Medicare Secondary Claims.

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Rebilling

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  1. Rebilling 2012 Annual Conference ADL DATA SYSTEMS, INC.

  2. RebillingFunctions • Process Rebilling Records • Edit Rebilling Records • Delete Claims from Electronic file • Print & Edit UB04 • Copy History file to Rebilling • Copy Current file to Rebilling • Using Rebilling for Medicare Secondary Claims

  3. Rebilling Menu / Billing Folder / Rebilling / Menu

  4. Rebilling using the BILLS option The BILLS tab is used for all of the rebilling options.

  5. Display – Resident Bills Residents Display to the left of the screen Resident History Records Display to the right of the screen

  6. Display – Bills Residents Resident History files Display to the Left Residents within the History file Display to the right

  7. Searching for a Resident Use the Date Range / Refresh to expand the Resident Search Use the scroll bar to find the resident Double Click on any Resident Account Number to find by Account #

  8. Fields updated from master file to rebilling

  9. Additional Fields

  10. Sample Medicaid Rebilling Process 1- Rebilling Program – Bills Option 2- Find Resident 3- Create Rebill.dat file 4- Double click on record to rebilled 5- Edit record if needed 6- Save Record 7- Continue with additional records or Exit 8- Sales Journal Rebill Only Option 9- Create Invoice 10- Create 837 file 11- Submit electronic file

  11. Example: Resident was denied by Medicaid for Incorrect Medicaid Number Using scroll bar find the resident or Double click on account number and enter resident account

  12. Create Rebill.dat file Must create the Rebill.dat file to enter the rebilling record Click Options Click Create Rebill.dat (System create a blank file rebilling file)

  13. Display History Record – Insurance Tab Medicaid Number was changes in the resident record and pulled to the rebilling record Edit any other changes needed to the history record

  14. Update Additional History Screens if Needed Occurrence Codes Tab Update any additional fields in the history screens as needed Update any additions TAB as needed

  15. Save Record when complete Click save Update Original Billing Record Y – Updates the history record and save to rebill file N – Does not update history record but save to rebill file

  16. Exit Rebilling when finish Click CLOSE to exit rebilling program

  17. Billing Wizard – Print Sales Journal Process Sales Journal use Rebilling File Only

  18. Sales Journal Verify Sales Journal to records been rebilled

  19. Create electronic file / Print UB04 Process Rebilling File : O -Only

  20. Create 837 electronic file for Submission Electronic file is created exactly like the current files

  21. Special Rebilling Options Click on the Options tab for Rebilling Options

  22. Edit & Delete Resident Records This option allows you to edit rebilling claims This options allows you to delete records from the rebilling file i.e. Can delete a resident record from the file before submitting file

  23. Copy Current Billing file to Rebill This step allows the user to copy a current billing file to Rebilling prior to posting to give the user the ability to delete claims from the file before submitting the electronic file • Example : Processing current Medicare A billing and want to submit the file without one resident • Process Current Medicare billing files & sales Journal • Rebilling Copy current bill file to rebill • Find resident to delete from record • Click on the Delete resident Claim option then exit Rebilling • Billing Wizard process steps using Rebill only option • Create electronic file • Post Billing

  24. Copy History file to Rebill • Find History file and Click on file • Click Options • Click Copy History to Rebill (Step copies previous billing history file to Rebilling file) • Reprint sales journal (Using rebill only option) • Reprint UB • Recreate electronic file

  25. Printing / Editing UB04 from Rebilling • Rebilling –Bills • Find Resident • Click Options • Click Print UB04 • Click Type Of UB UB can be edited Changes to the UB does not updates the resident history file

  26. Printing & Editing UB04 from Rebilling

  27. Using the UB-04 Editor 1- UB-04 Editor will edit the last UB created - By Generate Part B Bills - By Medicaid Invoices - By Private Invoices - By Medicare Invoices - By Rebilling

  28. Using the UB04 Editor Residents from the billing file will display to the right

  29. UB-04 History Save UB04 to History

  30. UB04 Editor Double Click on record to Edit UB04 Print UB

  31. UB04 Editor – Display UB Edit and Save UB04

  32. Medicare Secondary Using Rebilling Process for Medicare secondary Billing There are various type of Medicare Secondary Scenario’s Facility need to have all of the valid information required prior to creating the rebilling file Example: Resident was HMO from January 1 2010, bill HMO up to April 30 2010 Insurance Company paid up to March 31, 2010 and denied April Billing Need to bill Medicare Secondary for April 2010

  33. Medicare Secondary – Create Rebill.dat File • Rebilling Process • Bills • Click Options • Click Create Rebill.dat (Creates the Blank Rebilling file)

  34. Medicare Secondary – Find Record to Rebill • Bills / Residents – Bills • Find Resident Click on resident • Double Click on Resident History file to the right (History file will display)

  35. Medicare Secondary – Basic Insurance Info • Click on the Basic Insurance Info Tab • Click on Insurance Number 2 • Enter MEDICARE on the company Name

  36. Medicare Secondary – Insurance Pay Info Click on Insurance Pay Info Tab Click on Insurance Number 2 ( Enter relevant data) • Payer ID • Provider Number • Insured Name • Relationship Code • Insurance ID number • Etc.

  37. Medicare Secondary – Charge Details • Click Charge Details by Period • Click Insert • Enter Medicare Rugs Information 022 code and HCPC code etc.

  38. Medicare Secondary – Occurrence Codes • Click on Occur Code Tab • -Enter all relevant information • Condition Codes • Occurrence Codes • Value Codes

  39. Medicare Secondary - Remarks If Remarks are needed click on the remark tab and enter your remarks

  40. Medicare Secondary – Printing UB • After Completing Data Entry Print or Display UB04 to Verify • Click Print • Click Medicare Like Secondary • UB04 will display

  41. Medicare Secondary – Display UB Exit from UB and make any additional adjustment as needed

  42. Medicare Secondary – Save Click SAVE button when complete Update Original Billing Record Yes – Information entered will be saved to the history file and Rebilling File No - Does not save to history file only save to the rebilling file

  43. Medicare Secondary – Create Electronic file • / Billing / Billing Wizard / Medicare / • Enter Paysource • Produce printed bills – Option S Medicare Secondary • Create Submission File – Option 2 Diskette • Process Rebilling File – Option O Only

  44. Medicare Secondary – Create 837 file Input File Name – MCRTAP.DAT Output File Name - Enter file Name Submit file to Medicare One Example of Medicare Secondary Billing

  45. Rebilling 2012 Annual Conference ADL DATA SYSTEMS, INC. Questions

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