Kareo 101 Training Resources

Pulling the Billing Export Report

Navigate to the Reporting Dashboard and select Billing Export

Open

Select your filtering parameters.

• Date range (1)

• Funders (2)

• “Completed” requirements (3)

• Decide whether to include late entries (4) see helpful knowledge for more info

  Open

  

Then select Download File (5) to Excel.

• For more details on the billing export report and the “include late entries” feature, refer to https://rethinkautism.atlassian.net/wiki/spaces/RBS/pages/2676230254

  • “late entries” will only populate on the report once, so it is recommended to understand this feature before utilizing it.

• Best practice recommendations are to keep “completed” requirements to what defaults. This was set up under the company account as what was needed from a billable appointment to be seen as ‘completed’ and therefore, ready for billing.

Auditing (Scrubbing) the Billing Export Report

Once file downloads, audit data & save file once completed.

Syncing Claims into Kareo

Navigate back to Rethink → Billing Export report.

Confirm any previously selected filtering criteria remains.

Select Export to Kareo and upload scrubbed/audited file.

Billing Export Batches

Select the refresh button on the Billing Export Batches field to refresh the status.

If a Success status is returned, these claims are now present in Kareo for submission.

If a Failed status is returned, download the file and refer to https://rethinkautism.atlassian.net/wiki/spaces/RBS/pages/1973223764 for information on resolutions and resubmission.

Accessing Draft Encounters

Once all claims have generated a Success status, these claims will now be present in Kareo for submission to funders.

From the Kareo homepage, select Draft Encounters from the To Do List (or navigate to Encounters → Find Encounter)

Approving Draft Encounters

Draft encounters will populate here.

Select Actions → Approve to move claims into the Approved tab.

Select Actions → Save as Review to move claims to the Review tab.

• It is recommended to review/audit a few claims to ensure they are populating from Rethink correctly.

  • Double click a claim to review.

• Claims saved in the Review tab will remain here until they are approved.

Claim Submission to Funders

Once claims have been approved, navigate to Encounters → Submit Electronic Claims → Submit Claims to submit claims electronically to funders.

If claims need to be submitted via paper, navigate to Encounters → Print Paper Claims → Print Claims to print claims on CMS-1500 forms for submission to funders.

• The Submit Electronic Claims and Print Paper Claims sections will be, by default, inclusive and include all claims set to be submitted this way.

  • If this is not preferred, filter claims using the filtering criteria present.

Reviewing Clearinghouse Reports

Approximately 24 - 48 hours after electronic claim submission, a clearinghouse report will be generated.

This clearinghouse will give confirmation that the funder has received the claim(s) but it may also indicate a rejection has occurred.

To determine if a rejection is present, select the Clearinghouse Reports hyperlink from the To Do List (or navigate to Encounters → Clearinghouse Reports → Claim Processing).

Review the details here, if a rejection is present a number will be listed in the rejections column.

Double clicking on the rejected claim will allow you to review the rejection reason.

Alternative method of reviewing rejections:

• Navigate to Encounters → Track Claim Status → Rejections (from the drop down menu) → Find Now → Double click on claim.

• Hovering over the rejection reason in the transaction log will reveal the rejection reason.

  • Can also select Fix Rejection to reveal a pop up window with a hyperlink to assist in correcting the rejection.

  • For more information on rejections, refer to the Kareo Help Site for assistance. https://helpme.kareo.com/01_Kareo_PM