Billing Company Terms and Concepts

• Master Database: Master Databases house Libraries to be shared across individual Databases associated with the same company or entity. 
• Master Insurance Library
• Go-Live: The date that the Billing Company or Practice will use the PM as the main billing software.

• If this date changes significantly, please add a Mange Services (MS) Ticket.

• Libraries:

• Copy: A one-time copy from a specific database of your choosing that then exists independent of the database from which it was copied. 
• Link: Link a Library to the Master Library. 

• Any changes to one linked library going forward will reflect across all databases with the library linked to the Master.

• Load: One-time load from the system-delivered set of values from a client-provided file.

Things to Consider:

• Does the end client need access to the Database? 

• Create Custom Security Roles for the end client.
• Determine when to grant access to the end client.
• Schedule a training for office functions.

• Will the end client use the Calendar? If so, send this questionnaire to the end client.

• Add all Appointment Types, including blocks.
• Add and link all Resources to the correct Appointment Types.
• Add Slot Types.
• Complete a Schedule Build.

• Posting Payments

• POS field on Receipts can be useful 

• How do you bill your client? 

• Favorite applicable reports with any filters unique to the practice

• Share/copy suggested Key Reports and filters (if appropriate) with end client

New Database Request

• Necessary information to request a new Database:

• Practice Name
• EIN
• Group NPI
• Specialty
• Practice Address
• Desired Go-Live Date

• We suggest that you choose a Go-Live date at least 14 business days out from the day that the database request is made.
• A Data Conversion pushes the Go-Live date to 30-45 days after the Test File is received.
• If a new Interface is required for Go-Live, this will extend the necessary time to at least 90 days.

• Conversion (Yes/No)
• EMR Integration (Yes/No)

• Complete the Database Request Form.

Billing Company Database Setup Checklist

System Settings

• Set the Practice Name that will be Printed on Reports

User Maintenance

• Manage User Permissions/Roles

Pay To/Billing Locations

• Add Pay To/Billing Locations

Service Facilities

• Add/Modify Service Facilities
• Setup a CLIA Number (Optional)
• Setup the Block Address for Paper Claims

Billing/Rendering Providers

• Add Billing/Rendering Providers

• Link all Providers to the correct Facilities.

• Add the Appointment Resources to the Billing/Rendering Library.

Referring Providers (PCP)

• Add or Modify Referring Providers
• Referring Provider Import Tool

Procedure Codes

• Add Procedure Codes to the Procedure Code Library

Fee/RVU Management

• Add Charge Fees, Allowed Fees, and RVU Schedules

•     Ensure that all Fee/RVU Files are formatted as outlined in Fee/RVU File Formatting and Resources.

Statement Profile Setup

• Set up Dunning Messages.

• Statements System Settings (this step can be completed after Enrollments if necessary)
• Create a Test Statement Batch.

• This triggers the process for the generation of a Statement Proof by the Statement Department. This will require the Client's sign-off.
• If you are using POPS, your Account Manager will generate the test files.

Insurance

• Two Ways to Add a Payer List to the Insurance Library

• Use the Clearinghouse Payer List
• Manually add each Payer

Enrollments - Claims, ERAs, Eligibility

• Use Show Me How to view the Enrollment Dashboard Tour (Video) and see the Enrollments Overview.
• Start the Enrollment Process.
• Create Enrollments
• Paperwork is Downloaded and Re-Uploaded.
• Enrollments: Waiting on Clearinghouse
• Enrollments: Waiting on Payer Panel

Other Features to Consider (Not Critical to Go-Live)

• Tags
• Worklists
• Charge Management Rules
• ERA Management Rules
• Job Scheduler
• Transaction Codes
• Forms
• Premium Add-On Features