Data Process Flow

  • Add Referral/Patient
  • Enter Physician Orders Which Creates Unassigned Schedules
  • Assign Associates To Unassigned Schedules
  • Provide Service
  • Verify/Validate Service Provided To Create Both Payroll and Billing Records
  • Run Nightly Billing - Automated
  • Does Nightly Billing Meet Payer Requirements
  • No - Review Invoice Edits And Correct Information Required For Billing (Return to "Run Nightly Billing")
  • Yes
  • Create Billed Invoices
  • Manage A/R (Process Payments/Adjustments, Collection Activities)

Medicare Billing Edits

  • RAP's
  • Approved 485 orders sent to physician for signature
  • Locked OASIS record (Ready for transmission)
  • Verified first billable visit for the episode
  • FINAL CLAIMS
  • RAP Payment received and applied to invoice
  • All signed Physician orders received
  • All services verified for the episode (or canceled)
  • All OASIS records locked for the episode (Ready for transmission)