Rethink Billing FAQs
Prior to Pulling Billing Export
How 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.
How do I know if all appointments are connected to a valid authorization?
Follow all steps above, instead of clicking “Needs Verification” – leave as “All” and under Appointments with Billing Issues, select “No Authorization”
How do I know if there are any potential billing issues BEFORE I pull the billing export?
You can either use the filter identified in Q2 above or within the scheduler, review all appointments listed in ORANGE. This indicates billing issues within that appointment.
What 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.
Agency – only your group information will be listed on the claim in 24J and 31
Specific Provider – only this provider will be listed on your claim in 24J and 31
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
How 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.
How 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.
How 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
What do I do for staff overlaps?
For staff overlaps, we recommend viewing all appointments that have this validation error. Staff overlaps may occur for several reasons – groups, double booked appointments, etc. In order to determine how these lines should be handled on the billing export, the appointment scheduler and notes will need to be reviewed for those lines.
HELP! Why 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:
Date of Service (H)
Client (K)
Billing Code (N)
Modifier (O-P)
Authorization (V)
Place of Service (X)
Rendering Provider (AO)
How 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.
HELP! My billing export failed, what do I do?
First determine the reason the export failed. Did the entire export fail or did only a few lines on the export fail? As soon as you get a response from the export to Kareo in Rethink, download the file. Review the full spreadsheet and each line under the “Kareo Integration Status” column that gets added after you export (BL). If the line reads Success Encounter Id: 111111 – the line went through successfully. If the line reads and of the following – further action is required:
Failed: Unable to sync for appointment(ID: 1111111): No matching provider identified by first and last names. Provider listed in AO is not a provider listed in Kareo. Provider needs to be corrected on export or added to Kareo.
Failed: Unable to sync for appointment(ID:1111111): Diagnosis code 1 not found, service line 1 was not added. Encounter cannot be created with service line errors Diagnosis code listed on export is missing/not a valid ICD-10 diagnosis code and needs to be updated on the export and within client chart.
Failed: Unable to sync for Encounter ID: 1111111 This is a warning returned from the integration, Encounter should be listed in Kareo regardless of failed status (if encounter ID is returned, use to find in Kareo) no further action required.
If no response is returned on the export, check the failed message within the batch list. If it reads “Couldn’t Read Batch File to Sync with” – there was an issue reading the export. Check the formatting of the export (were any columns deleted? Hidden? Etc.).
How do I verify that all my charges went through to Kareo successfully?
You can compare the billing export to your encounter summary in Kareo for a quick check to assure all lines DID go through successfully. Use the totals on the billing export (if adjustments were made on the export, be sure to re-total up all charges) and compare against the Encounters Summary report in Kareo. Reports – Encounters – Encounters Summary. Switch date to “today” and compare all drafts sent over (total charges) to total charges listed on Billing Export.