10 likes | 256 Views
Provider Direct Billing Workflow **DRAFT**. Service Month. 1 st 5 th. 6 th 15 th. 16 th 20 th. 21 st EOM. Finalize Monthly Authos & ensure all data entry is complete before generating Service Orders Generate Serv Orders and inform Provider.
E N D
Provider Direct Billing Workflow **DRAFT** Service Month 1st 5th 6th 15th 16th 20th 21st EOM Finalize Monthly Authos & ensure all data entry is complete before generating Service Orders Generate Serv Orders and inform Provider Run Service Delivery Rpts to ID Provider billing status Adjust SAMS data to reflect additional authorizations Finalize Bill Generate Agency Invoices Verbal Service Authos Suspensions Schedule Changes Data Entry ASAP Confirm Final Bill Amount Sync Serv Plan Remediation Activity Resubmit fixed items Second pass remediation if needed Provide ASAP with the finalized billed amount Verbal updates to ASAP Suspensions Schedule Changes Retrieve PD Authos Discrepancy Review* Perform Services Adjust for post month authos Prepare Deliveries Provide ASAP w/ Monthly Billing Coversheet before upload PD Service Delivery Due Issue Log Generation Issue remediation due Run Delivery Rpts to finalize anticipated payment PROVIDER *Discrepancies in service plan data between provider and ASAP need to be identified, communicated and fixed throughout the service month. ** Billing Disputes – Depending on the complexity of the billing dispute, resolution may or may not happen during the billing period.