Billing
For over twenty (20) years, ClaimTrak has offered its customers a solid Billing Module which focuses on each organization’s core operational needs. You won’t find a more comprehensive, yet flexible Billing Module than that offered by ClaimTrak.
The ClaimTrak system comes standard with multiple HIPAA compliant file formats such as 997, 837, 270, 271, 277 and 835. In addition, ClaimTrak has the ability to process various proprietary formats with minor updates.
There are three types of billing processes available in the ClaimTrak system:
- Charge Batch Entry
- Scheduler
- Progress Note
Progress Note billing is recommended as it is most efficient; claims are automatically created from electronically signed progress notes.
Third-Party Billing
The Billing Module supports the latest revision to the CMS health insurance claim form and the latest revision to the Universal Billing form by printing the appropriate client demographic, encounter information and codes in the designated blocks on the forms. ClaimTrak customers have been successfully submitting electronic Medicaid and Medicare claims since October 2003.
In addition, ClaimTrak has incorporated several standard edit and error checks to minimize the number of denied claims. The module maintains a filing sequence for insurance coverage and is able to process and manage cascade billings between third party payers (Waterfall Method).
All claims are posted in a batch. Because the ClaimTrak system has open-item billing (billing by claims as opposed to balance), the payments can be split in the batch across multiple services.
The Billing Module has the capability of tracking clients whose eligibility for third-party reimbursement for health care service changes over time, allowing staff to appropriately write-off any balance amount on a claim or group of claims.
Routinely used to enroll, access and close client data electronically using 834 transactions in conjunction with payor(s) proprietary assessment formats, this module is also used for transmitting electronic claims and encounters in both 837Institional and 837Professional formats as well as payor proprietary formats. In addition, the ClaimTrak system receives remittance advice electronically for the 835 transaction and other payor proprietary formats.
The Billing Module offers the ability to transmit and accept miscellaneous records (i.e. transportation services, referrals, subcontractor services, rosters, etc.) on a customized basis.
Custom Billing
The Billing Module provides convenient management of client and third-party billing. The ClaimTrak system will track and report client bills in a manner that allows clients and payors to easily understand the status of their accounts. The ClaimTrak system will support multiple encounters per day, both real-time and batch entry.
Also, the Billing & Module will handle any agency billing specifications for any program including minimum fees, sliding fee scales, billing in various units of measure (e.g., 30 minute intervals) and health plan deductibles and co-payments. This module has the ability to automatically calculate adjustments to a client’s bill in view of the client’s sliding fee category and will allow for multiple fee schedules and sliding fee schedules on a program basis and multiple payors for a given encounter. In addition, the module will apply different schedules and sliding fees to individual types of services and procedures in an encounter.