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Prior to Pulling Billing Export

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titleHow do I know if all appointments have been verified?

You can easily run a quick report in Rethink to check that all appointments for any given date range have been verified.

  • Rethink – Scheduling – Appointment List

  • Click the filter icon to view all filters available

  • Adjust your date range 

  • Client should read “ALL”

  • Staff should read “ALL”

  • Appointment Type – adjust according to what you want to pull (note: billing export only pulls BILLABLE appts) 

  • Appointment Status switch to “Needs Verification”

 

  • Click “Submit”

This will pull all appointments that will NOT be listed on the billing export for that given date range.

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titleWhat provider should be listed on my authorization?

This will all be dependent on your payor contracts. It’s important to remember that the provider you list here is who will pull into the claim in box 24J on the service line.

  1. Agency – only your group information will be listed on the claim in 24J and 31

  2. Specific Provider – only this provider will be listed on your claim in 24J and 31

  3. Provider Assigned to Appointment – whichever provider is assigned to the appointment will be listed on your claim in 24J and 31 (typically used for Medicaid & Tricare funders)

Billing Export

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titleHow do I fix appointments not attached to an authorization? 

Go into the appointment on the scheduler and under the “service” section, select the active/valid authorization. Within the billing export, if there is a valid authorization now attached to the appointment, you can manually enter the authorization number in the Authorization # column (V) on the export.

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titleHow do I fix clients missing a diagnosis? 

Diagnosis are listed within the client chart in Rethink. If a diagnosis is invalid or missing on the billing export, you will need to go into Rethink, into the client chart and find the “Diagnosis” section. Add the diagnosis here or update if necessary. Once that is completed, go into the client authorization and update the diagnosis attached to the active authorization for that client. Once this is complete, you can manually enter the diagnosis in the Diagnosis Code column (AA) on the export.

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titleHow do I adjust for client overlaps?

Depending on payor policy, you’ll need to adjust client overlap to account for concurrent billing rules. To adjust for client overlaps, watch this video: Adjustments for Overlap Billing

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titleWhy are my lines not combining for same service?

Do you have the particular funder listed on the billing export to combine charges (Company Account – Funders)? Are you combining based on procedure or based on procedure/rendering provider? If the combine settings are listed properly, do the lines on the billing export contain the same in each of these columns:

  1. Date of Service (H)

  2. Client (K)

  3. Billing Code (N)

  4. Modifier (O-P)

  5. Authorization (V)

  6. Place of Service (X)

  7. Rendering Provider (AO)

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titleHow do I fix appointments not attached to the correct rendering provider?

Rendering providers (AO) pull from the authorization. If the incorrect provider is showing on the billing export, go into the authorization within the client chart and update the provider there. Remember that the provider listed here is who pulls into the claim under box 24J.