Release Notes for Billing Module Updates in Therap 2012.0

A brief outline of the Billing Module features introduced in version 2012.0:

Billing updates for Users in Kansas

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Validation for total number of Billable Units per month

The total number of billable units per month has been set to a maximum of 23 units. If more than 23 units of Service is provided for an Individual, the extra units are not considered for billing data calculation.

Validation for total number of Billable Units per year

The total number of billable units per year has been set to a maximum of 260 units. If more than 260 units of Service is provided for an Individual, the extra units are not considered for billing data calculation.

Insufficient Remaining Units

If there are insufficient amount of Remaining Units left in the Service Authorization and if the actual units billed exceeds the remaining units then a message will be shown to the user when generating Billing Data.

Weekly Limit with 2 Service Authorization

A weekly limit of 5 units have been applied when there are two Service Authorization for an Individual for the same service and week.

For more information on the Kansas Day Hab section [click here.]

5010 specific changes

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Professional Claim

For agencies whose payers are 5010 compliant, a warning will be shown if the Primary Diagnosis Code and Diagnosis Pointer are not entered while adding service for a Professional Claim type Service Authorization.

Institutional Claim Template

For agencies whose payers are 5010 compliant, a warning will be shown if the Admission Type and Patient Status drop-down needs to be selected from the drop-down menu.

General Billing Updates

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Warning Message for blank Funding Source in Service Authorization form

A warning message will be displayed if the Funding Source field on the Service Authorization form is left blank.

For more information on this section click here.

Claim Form link column in Reconciliation Report

A claim form link has been added in the Reconciliation Report. Users will be able to open an Individual's Claim Form from the Reconciliation Report.

For more information on this section click here.

Increased number of Cost Center Type Options

Number of Cost Center Type options fields have been increased. Users will now be able to enter twenty cost centers under a particular cost center type.

For more information on this section click here.

ISP Billing in Institutional Claim

Users will now be able to select 'ISP Data' as Method of Data Collection when adding a Service for Institutional Claim in a Service Authorization form. The method of generating billing data remains the same as in Professional claims.

For more information on this section click here.

Transaction Search

Users will be able to search for Transaction Records with the Claim Tracking ID aside from the existing search parameters.

Payer field introduced in search forms

Users will now be able to search with the 'Payer' field as a parameter along with other parameters in Reconciliation Search form, Transaction Search form, Claim Search form and Claim submission form.

Providers with only one payer will view only that payer's name beside the Payer field

Denied Claim Report

Denied Claim Report will not be generated for Manual Claims.

Remittance 835 upload

A remittance file with the same name cannot be uploaded into the system .A warning message will be displayed, if a user tries to upload a file with a same name (that already exists in the system).

For more information on this section click here.

Billable Option for ISP Program

A new field Is Billable ISP Program has been added under the Other section of the ISP Program form. If this option is selected as 'Yes', the Billable field under the Other section in the ISP Data form will be automatically selected as Yes.

For more information on this section click here.

New Field added in Billing Summary Report

A new checkbox field, Status have been added under the Output Columns section of Billing Summary Report. Users will now be able to view a Status column as an output column for the Billing Summary Report.

For more information on this section click here.