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Billing Module - Admin Guide

Billing Module - Admin Guide

Description: In this guide, the user will learn about the billing module.

Roles Required: Super User, Billing Team

Permissions Required: N/A

Contents:

Overview 

The billing module allows users with the billing role to review, batch, process, approve and reconcile entries for billing purposes. The system will generate a billing file with all necessary data that can be used to create the documentation needed to send to funding sources for payment. 

Employee punches can be processed in billing batches and exported on a transmitted file that can be imported into the company’s billing system. The billing module includes the following functions:

  • Batches - Create billing batches

  • Punch Entries - View, search, and batch punch entries

  • Billing Entries - View and search for billing entries

  • CPT/HCPCS Codes - Search by client name and service code to view

  • Unbillable Entries - View, search, and act on unbillable entries

  • Previously Billed Entries - View, search, and batch previously billed entries

  • Various profiles including Employees, Clients, Residential Programs, Day Programs, Group Services, and Parenting Programs - Search and view details

  • Funding Sources - Search and view details

  • Cost Centers - Search and view details

  • Rollups - Search and view details

  • Reconcile - Reconcile billing batches

Create New Batch

The Batches submenu tab is the landing page for the billing module. The table will list all batches in the system. Use the filters to search for a particular batch. Batches can be created from either the Batches page or the Punch Entries page.  

To create a new batch from the Batches page:

  1. Log in to DCI with an appropriate profile

  2. Click Billing on the main menu

  3. Click Batches on the submenu

  4. Click Actions

  5. Select New Billing Batch from the drop-down menu

  6. Complete the Create Batch form

    1. Name (required): Give the batch a name that can be easily recognized

    2. Description (optional): This could include the dates of the billing period

    3. Up to Date (required): Specify the range of entries to include in the batch. The up-to-date will be the latest date of service. The system will include any available entries before that date.

    4. Funding Source: One batch will be created per funding source

      1. To create a bulk batch for the funding source, do not specify any further criteria and skip to step 7.

    5. Cost Center Code (optional): Leave blank to include all cost centers, use a wildcard to include cost centers that start with the same characters (i.e., to include all AZ cost centers, type AZ*), or type a specific cost center.

    6. Service Code (optional): Leave blank to include all service codes for the specified funding source and units (see below), use a wildcard to include service codes that start with the same characters (i.e., to include all 151 service codes, type 151*), or type a specific service code.

    7. Account Type (optional): The service account type

    8. Client Name (optional): Leave blank to include all clients or type a specific client name

    9. Units: Only one unit type can be included in a single billing batch

    10. BatchesCustomField (optional FI mode field)

  7. Click Next

  8. On the Batch Summary page, review the information, then click Save and Yes to confirm.

The batch is now submitted, and the system shows the batch details page. The batch is in pending status and must be validated. Process as normal.

Create New Batch by Punch Entries

The Punch Entries submenu tab within the billing module lists all entries that are ready to be processed. Entries that have been approved and do not violate an authorization max (remaining balance, daily max, weekly max, or monthly max) will appear in this table. Entries include:  

  • Hourly Punch Entries  

  • Residential Program Attendance Entries  

  • Residential Program Absence Entries  

  • Day Program Attendance Entries  

  • Group Service Attendance Entries  

  • Parenting Program Attendance Entries  

  • Parenting Program Absence Entries  

  • Client Transportation Entries  

  • Transportation Entries  

  • Vendor Payment Entries (FI Mode Only)

New billing batches can be created directly from the Punch Entries page:  

  1. Log in to DCI with an appropriate profile

  2. Click Billing on the main menu

  3. Click Punch Entries on the submenu 

  4. Select the header check box to select all listed entries or select the check box next to each entry to include in the batch 

  5. Click New Batch

  6. Enter a name for the batch (required) and a description (optional)

  7. Click Next

  8. Review the entries and click Save

The batch is now submitted, and the system shows the batch details page. The batch is in pending status and must be validated. Process as normal.

Create New Batch by Payroll Batch

To create a new batch from a payroll batch on the Batches page:

  1. Log in to DCI with an appropriate profile

  2. Click Billing on the main menu

  3. Click Batches on the submenu

  4. Click Actions

  5. Select New Billing Batch from the drop-down menu

  6. Click the blue Select From Payroll Batches button at the bottom of the page

  7. Use the filters to find the desired batch and click Search

  8. Select the checkbox next to the desired batch

  9. Click Save

  10. Add batch name (required) and description (optional)

  11. Select the checkbox next to it at the bottom of the page

  12. Click Next

  13. On the Batch Summary page, review the information, then click Save and Yes to confirm.

The batch is now submitted, and the system shows the batch details page. The batch is in pending status and must be validated. Process as normal.

Create New Batch by External File

To create a new batch from an external file on the Batches page:

  1. Log in to DCI with an appropriate profile

  2. Click Billing on the main menu

  3. Click Batches on the submenu

  4. Click Actions

  5. Select New Billing Batch from the drop-down menu

  6. Add batch name (required) and description (optional)

  7. Click the blue Add From File button (see example file headers below)

  8. Click Upload tab delimited TXT file and locate the .txt file to upload

  9. Click Open

  10. Click Next

  11. Review batch summary

  12. Click Save and Yes to confirm

The batch is now submitted, and the system shows the batch details page. The batch is in pending status and must be validated. Process as normal.

Example file headers:

Field #  

Field   

Type  

Description  

Required  

Comments  

1  

EntryId  

Integer  

Unique identifier for the entry or entries

Yes  

Client entry ID under the client funding account

Add Entries to Existing Batch

To add entries to an existing batch from the Punch Entries page:

  1. Log in to DCI with an appropriate profile

  2. Click Billing on the main menu

  3. Click Punch Entries on the submenu

  4. Click the check box next to the entries to add

  5. Click Add to Existing Batch

  6. Select the batch to add the entries to

  7. Click Save and Yes to confirm

The batch is now submitted, and the system shows the batch details page. The batch is in pending status and must be validated. Process as normal.

Remove Entries from Existing Batch

Entries can be removed from an existing batch before the batch is processed:

  1. Log in to DCI with an appropriate profile

  2. Click Billing on the main menu

  3. Create a batch and follow the steps to arrive at the Process Batch page

  4. Before processing, scroll down to the bottom of the page to review the entries.

  5. Click the checkbox next to the entries to remove

  6. Click Remove and Yes to confirm

The entry is now removed but is available for processing for future batches. Continue processing the batch as normal.

Split Batch

Batches can be split from an existing batch before the batch is processed:

  1. Log in to DCI with an appropriate profile

  2. Click Billing on the main menu

  3. Create a batch and follow the steps to arrive at the Process Batch page

  4. Before processing, scroll down to the bottom of the page to review the entries.

  5. Click the checkbox next to the entries to split

  6. Click Split and Yes to confirm

The batch is now split creating two batches in pending status. Continue processing the split batches as normal.

Merge Two Batches

To merge existing batches from the Batches page:

  1. Log in to DCI with an appropriate profile

  2. Click Billing on the main menu

  3. Click Batches on the submenu

  4. Locate one of the batches to merge by using the Search functionality or by scrolling through the table

    1. The batches to be merged must be in a pending status. If already processed, they can no longer be merged.

  5. Click anywhere in the pending batch row to open the batch details page

  6. Click Merge

  7. Add batch name (required) and description (optional)

  8. Select the batch from the list to merge

  9. Click Save and Yes to confirm

The batches are now merged. Continue processing the batch as normal.

Batch Details

The Batch Details page will show:

  • Actions Menu

    • New Note

    • New Attachment

    • Edit Batch: Change the name and description of the batch

    • Edit Custom Field Values: Add additional batch fields specific to the organization

  • Green button: The label will change depending on the batch status

  • Batch Details window

    • Batch id: Unique system id number

    • Date: Date the batch was created

    • Status: Current status of the batch

      • Pending

      • InProcess or Process Started

      • Processed

      • ApproveInProcess

      • Approved

      • Transmitted

      • Reconciled

    • of Credit Entries: Total number of positive entries

    • of Debit Entries: Total number of negative entries

    • Credit Total: Total amount of positive entries

    • Debit Total: Total amount of debit entries

    • Rounded Amount: Total amount rounded (this plus the debit total should equal the credit total)

    • of Client: Total number of clients who have entries in the batch

    • Funding Source: The funding Source that the batch is for

    • Units: Unit type

  • Tabs: Entries, Rollups, Notes, Attachments, Events, Custom Fields, History

Billing Override

To override the information in a billing entry before the entry is processed:

  1. Log in to DCI with an appropriate profile

  2. Click Billing on the main menu

  3. Click Billing Entries on the submenu

  4. Search for the billing entry to override

  5. Click anywhere in the row to open the entry details

  6. Click Actions

  7. Select Edit Entry from the drop-down menu

  8. Update with the override information

  9. Click Save and Yes to confirm

The billing override is complete and can be processed as normal.

Billing Entries

The Billing Entries submenu tab lists all existing billing entries. This table is a great way to look up details of individual billing entries, including status. Billing entries in approved status can be edited by the following steps:

  1. Click Billing on the main menu

  2. Click Billing Entries on the submenu

  3. Filter and search to find the entry to edit

  4. Click anywhere on the entry to open the Billing Entries Detail page

  5. Click Actions

  6. Select Edit Entry from the drop-down menu

  7. Edit as needed

  8. Click Save and Yes to confirm

The edits will appear on the entry details page and will be applied to the transmitted file after the batch is approved.

Batch Processing and Statuses

Pending Status

When a batch is in Pending status the user can:

  • Search, filter, and view entries

  • Add Notes and Attachments

  • Refresh the Billing Rate

    • Click the blue Refresh Billing Rate button to update rates for any entries that had a rate change after being approved

  • Remove entries

    • Select the checkbox next to desired entries

    • Click the red Remove button

    • Click Yes on the confirmation window

  • Remove all entries to cancel the batch

    • Select the checkbox in the table header to select all entries

    • Click the red Remove button

    • Click Yes on the confirmation window

    • The batch will have a status of canceled

      • Please note: No action can be taken on Cancelled batches

    • Split the batch into two batches

      • Select the entries to split

      • Click the gray Split button

      • Complete the wizard and click Save

      • A second batch will be created in Pending status with the selected entries

    • Click Process to start processing the batch

Processed Status

After clicking Process, the batch will move to InProcess status. No action can be taken on the batch during this time. Users can navigate to other pages or log out while the batch processes. The system will send a notification when the process is complete. Processing a batch will create a corresponding billing entry for every punch entry. The system will complete any necessary actions such as rounding and/or multiplying hours to units per billing multipliers.

When a batch is in Processed Status the user can:

  • Search, filter, and view entries

  • Add Notes and Attachments

  • Edit individual billing entries

    • Click the billing entry to open the details page

    • Click Actions

    • Select Edit Entry from the drop-down menu

    • Edit as needed

    • Click Save and Yes to confirm

    • Click the blue hyperlinked Batch Name in the Billing Entry Details box to return to the batch details page

  • Click Approve to approve the batch

Transmitted Status

After clicking Approve, the batch will move to Approve InProcess status. No action can be taken on the batch during this time. Users can navigate to other pages or log out while the batch processes. The system will send a notification when the process is complete.

Approving a batch will update the following statuses:

  • Batch status will update from Approve InProcess to Transmitted

  • Billing entry statuses will update from Pending to Approved

When a batch is in Transmitted status the user can:

  • Search, filter, and view entries

  • Add Notes and Attachments

  • Download the Raw Billing Dump file

    • The data in this file can be used to create any necessary documents to submit billing to the funding source

    • See instructions below

Reconciled Status

Reconciled status means that at least a partial payment has been received for the entries. The same actions listed under Transmitted Status above can be taken when a batch is in Reconciled Status.

 

Reconcile

Billing batches may be reconciled after the organization has received payment for services provided. This helps track which entries are still open or waiting for payment. Entries cannot be reconciled more than once. The initial amount that was reconciled is the billable amount. Write-off entries are not reconciled.

Download Raw Billing Dump File

After a payroll batch has been processed and approved, the system will generate the raw billing dump file. This file contains data that will be required to reconcile the batch and can be used to create any necessary documents to submit billing to the funding source. The green Reconcile button displays and the batch status is transmitted.

If on the final step of processing a batch and have the batch details page open:

  1. Scroll down the page to click the Attachments tab

  2. Locate the file that begins with RawBillingDump

  3. Click the blue Download Arrow Icon to start the download