Billing

An effective and efficient billing cycle is a key factor in reducing costs and improving collections. The Clinic Controller: Therapy team has worked side-by-side with billing personnel and managers to optimize charge entry, carrier and patient billing, transaction posting, and insurance statusing.

Claims

The first component of billing is claim generation. Clinic Controller: Therapy examines every checked in visit that is still unbilled and through a rigorous scrubbing and validation process, classifies it as billable or non-billable. Non-billable visits are displayed on a report that lists the problem and provides interactive links to the visit’s case and transaction screens, enabling problems to be quickly corrected. Billable visits are displayed on a screen that offers complete flexibility in selecting the billing method and medium.

Once a claim is output as either a fully 5010 compliant CMS 1500, CMS 1450, ANSI 837P, ANSI 837I (or as a custom format) a copy of it is stored in the archive. At any time a user can retrieve any claim that has ever been output and recreate it exactly as it was sent originally.

Currently Clinic Controller is ranked as the number one vendor with the clearing house Trizetto as the vendor with the cleanest claims, with a current acceptance rate of 98.5%.

Posting

As a direct result of our focus on therapy, Clinic Controller: Therapy employs a payment posting model that fits the way money flows through outpatient therapy clinics. Patient and Carrier payments may be posted to the system at any time, even if they’re not immediately applied.  This greatly simplifies payment handling and encourages payment collections. In fact the Schedule, by virtue of our strong integration, allows front office personnel to view balance  status for patients and post payments without having to leave the Schedule screen.

The posting screens provide simple and efficient payment entry. Our payment application screen reads like an EOB and is designed to expedite the posting process and eliminate posting errors.

Smart filtering displays only the patients and visits eligible for payment application, which expedites entry and eliminates cross-posting errors. Contract information is displayed, so the poster is immediately aware of payment accuracy. As a result of our posting model, all of a patient’s outstanding payments can be applied in basically a single click. The screen also offers convenient right-click access to per diem payments, payment adjustments, and notes.

Electronic Remittance Advice / Auto Posting

Clinic Controller: Therapy has fully supported posting of 835 EOB’s received from your clearing house or carrier since 2007. This is the number one time saver for billers and posters.  Our Auto Posting feature gives the biller as much control when auto posting as they have when manual posting with the added benefit of not having to key in all of the numbers.

Legible Ledger

Many systems on the market today have patient ledgers that do not show enough detail. The screen shot below is an example of a patient ledger.

The top portion contains all of the dates of service, which expand to show all of the charges, which further expand to show all of the transactions against that charge.  In the example below for the visit on 1/16 there were 2 charges, 97110 and 97140.  The 97110 had 2 payments applied against it, one from Aetna and one from the Patient.  Clicking on the payment line populates the detailed panel at the bottom where we can see where this payment came from, in this case it came from a $3,802.52 check that was Posted on 2/2 and physically entered on 2/5.

 

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