Edit Encounter Charges and Resubmit Claims

Your practices receives many different electronic responses to claim submissions and billing. Read this article to learn the different EDI responses, which responses require attention, and how to use PCC's tools to review and respond.

After you submit claims, your practice will receive clearinghouse and payor acknowledgements as well as ERAs and other electronic notifications from PCC, claim clearinghouses, and payors. You can use tools in PCC EHR to review these responses. When you need to do deeper research, you can use the EDI Reports (ecsreports) program.

Use the Claims tool to process and submit claims to insurance companies and other payers, work on claims that could not be submitted, and review a log of submissions.

You may need to assign a billing provider to an encounter after it has been posted. Use the Edit Charges in the patient's Billing History to make changes.

If you post a payment and later discover the procedure or payment was a mistake, you may need to "relink" the payment to different procedure.

Use the Edit Charges feature in the Billing History in a patient's chart if you need to edit diagnoses, procedures, or other encounter or claim information. For example, you can change the place of service, the provider of service, responsible party for each charge, copay amount due, billing provider, and other information. After you make changes, you can queue up a new claim.

You can change the responsible payor for any charge on any encounter, and change the portion of the charge that is the copay.

The Daily Check program (dailycheck) lists all the visits posted on a single day or range of days. The report includes every diagnosis, procedure, amount charged and payment posted. Use dailycheck to review a day's postings.

As you bill for an encounter or troubleshoot problems with a claim, you can keep encounter-specific notes that are attached to the billing history of the encounter.

If a secondary insurance requires the EOB from the primary, or any claim requires a certificate of medical necessity, discharge summary, or other clinical documentation, you need to send an attachment to the payor. You can edit the encounter and add an attachment code to an encounter, generate a unique attachment ID, and specify the attachment type and method. Attachment information will then be sent with the electronic claim.

Use this new user training outline to learn how to complete billing tasks in PCC.

You can quickly and easily reconcile personal payments that your practice has posted in PCC EHR. Run the Payment Reconciliation report in order to prove out, checking against your cash drawer and records at the end of the day or the end of your shift.

As you post charges, you can review and update patient information (like insurance eligibility), double-check the linking and codes that the clinician selected, and post any payments received.

Learn how to schedule, chart and bill a telemedicine visit with PCC.

You can adjust an encounter’s place of service when you post charges. Sometimes you need to change the place of service of an encounter after the charges have already been posted. Select the encounter in the Billing History in the patient’s chart. Then click “Edit Charges”. Next, edit the encounter’s location, or any other information […]

Read this article to learn about configuration options and implementation recommendations for the Post Charges features in PCC EHR.

Use the Schedule and Messaging queues in PCC EHR, along with the Encounters by Billing Status Report, to ensure that your practice has posted charges for every encounter.

Learn how to post a forms fee or any other administrative charge that could occur outside the context of an appointment.

Read this procedure to learn how to create a hospital encounter on a patient's chart, post hospital diagnoses and charges, adjust claim information, and queue up a claim.

Use the Billing History in a patient's chart to see full details of what was billed for an encounter, what payments were collected, when claims were sent, acknowledged, and received, and more.

Learn how to change the copay due on a charge. You may need to do this after charges have been posted and a claim has been filed.

When your practice needs to prevent certain claims from being submitted, you can create a claim hold. A claim hold prevents claims from going out for specific dates of service, billing providers, places of service, and insurance plans. You can also configure your practice’s claim delay, which prevents any claim from going out until a certain number of days after the date of service.

After you prepare and submit claims, you must deal with claims that could not be submitted or were rejected.

What kinds of pre-submission processing does your PCC system do on claims? What errors can it find, and how do you fix them?