Sandata Agency Management 01-Billing Review Window

The Billing Review window displays visits that match the criteria selected. Users can prepare items for invoicing, perform exception handling, or make other edits and corrections as needed.

To search Billing Review:

Go to the Billing Review window under Main Menu > Billing.
Select the appropriate search criteria.
Select Refresh.

The Billing Review window allows a 30 day date range to be reviewed without selecting a Payer. If the date range exceeds 30 days, a Payer must be selected. By default, all visits display for the selected date range. Select the Show Only Items OK to Bill checkbox to display the billable events for the selected date range.

Search Filters Closed

The Search Filters allow users to narrow the Results List to meet specific criteria. It is possible to use a particular field as well as a combination of fields.

Field	Description
Admission	Use this field to filter Clients by name.
Company	Use this field to filter visits for the associated company.
Location	Use this field to filter visits for the associated location.
Admit Type	Use this field to filter visits by the admission type.
Team	Use this field to find visits by the associated team.
Payor	Use this field to filter for visits by the associated Payer.
Billing Frequency	Use this field to filter visits by their billing frequency.
Rate Plan	Use this field to filter visits by available rate plans.
Service	Use this field to filter visits by the associated service.
Type	Use this field to filter visits by their billing type.
Event	Use this field to find visits by the associated event code.
Status	Use this field to filter visits by the selected status.
Not OK To Bill Reason	Use this field to filter visits by their exception reason.
Date From	Use the selected to and from date to filter results by visits that occurred within the selected date range.
Date To
Time Range	Use the selected time range to filter results by all visits that occurred within the selected time frame.
Weekday	Select these checkboxes to filter visits by a specific day of the week. Each box represents a different day of the week (Monday to Sunday).
Show Only Items OK to Bill	Select this checkbox to filter for visits marked OK To Bill.
Show Only Items NOT OK to Bill	Select this checkbox to filter for visits marked NOT OK to Bill. These visits need exception handling before they are OK to Bill.
Show as Summary	Select this checkbox to view all results in the summarized format.

Results List Closed

The Results List displays all visits matching the selected search criteria.

Field	Description
Date	Displays the date of service.
Client	Displays the Client’s name.
ChartID	Displays the Client’s assigned ChartID number.
Service	Displays the code associated with the service received.
EC	Displays the event code.
IN	Displays the call in time.
OUT	Displays the call out time.
TZ	Displays the agency’s time zone.
Quantity	Displays the total hours between the visit’s call in and call out.
Units	Displays the billing quantity for the visit, converted to units. Units are defined based on how the service is billed.
Rate	Displays the service rate for the visit.
Flags	Displays any flags associated with the visit.
Amount	Displays the total billable amount of the visit.
Copay	Displays the copay amount.
Supplies	Displays the dollar amount for any supplies used.
Status	Displays the status of the visit.
PRN	Displays the PRN rate for the visit.
Override	Displays a Y if there are overrides associated with the visit.
Authorization Number	Displays the ID number associated with the selected visit’s authorization.
Authorization Quantity	Display’s the number of authorized units for a visit.
Tasks	Displays the number of tasks entered during the visit.
OT / AB Hours	Displays OT / AB Hours entered during exception handling.
OT / AB Code	Displays OT / AB Codes entered during exception handling.
Not OK to Bill Reason	Displays exceptions that must be resolved before the visit can be billed.
Payor	Displays the Client’s Payor.

Summary Block Closed

A summary of all events displayed is shown. If there are events selected, the total for those events will be displayed on the right side of the totals bar.

Field	Description
Items	Displays the number of visits matching the search criteria.
Visits	Displays the total number visits.
Hours	Displays the total number of billable hours.
Units	Displays the total number of billable units.
Pending / Hold	Displays the total number of visits marked Pending/Hold and the billable amounts.
Confirmed	Displays the total number of visits marked Confirmed and the billable amounts.
Billed	Displays the total number of visits marked Billed and the billable amounts.
Total Hours	Displays the total number of hours for visits and the billable amounts.
Visits without Equivalency	Displays the number of visits without equivalency.
Copay	Displays the copay total for all visits.
Supplies	Displays the supplies total for all visits.

Open Item in a Results List Closed

Double click or right-click and choose Open on any item to view the schedule.

Navigate To Option Closed

Occasionally a visit contains exceptions that must be resolved before an invoice can be created. The Navigate To option allows users to immediately open a Client profile, correct any issues and then return to the previous screen.

Select the visit from the results list.
Right click to open the dropdown menu and select Navigate to: > Client.
This opens the General section of the Client’s Admission.
Resolve any necessary conflicts.
Select Save.
Select Close.

The user is then returned to the Billing Review window.

Select All Select None Closed

Select All or Select None highlights all items in the Results List or deselects any items previously selected item.

It is also possible to select multiple items by holding the Ctrl button while selecting items. To select multiple items in a row, hold the Shift button and select the first and last item.

View

Two formats are provided for displaying events: Details and Summary. The Summary View can also be activated by checking the Show As Summary option in the Filters section.

Right-click and choose View.

The default view is Details.

Details View: The Details view offers an in-depth overview of each visit matching the search criteria.

Summary View: The Summary view condenses clients with multiple events into a single line. Summary view contains less information but offers a more digestible view of the search results.

Set Status Closed

On the Billing Review window, Set Status can be used to change the status of events without having to open the Schedule Detail window. This is helpful for tasks such as bulk editing or getting an item ready to bill after resolving an exception.

The list of available statuses is based on agency / Payer configuration.

Select an event or several events in the Results List.
Right-click and choose Set Status.
Select a status from the dropdown menu.

The new status will be applied to all selected visits.

Create Invoices Closed

The Create Invoices window allows users to generate invoices to be sent to a Payer or client for payment. The Create Invoices button is in the top right corner of the Billing Review window.

Field	Description
Invoice Date	Use this dropdown to select a date for the invoice.
Due On	Use this field to indicate the invoice’s payment due date.
Comments	Use this field to enter any notes about the invoice.
Print All Invoices Created	Select this checkbox to print copies of all invoices being created. Invoices are generated in a printable PDF format after the creation process is completed.
Print A Summary Report	Select this checkbox to print a summary report of all invoices being created. This report can be used as a sales register.

Create an Invoice Closed

To create an invoice:

Go to the Billing Review window under Main Menu > Billing.
Next, select all applicable filters.
Select the Show Only Items OK to Bill checkbox.
Select Refresh.
Select Update.
Then select the Create Invoices button.
Edit the Create Invoices fields as needed.

Select the Validate Transfers button when it displays to verify the correct service rates for the Payer. If there are no issues, the following message displays.

If there are problems with the service rates, select the Use Master Rates checkbox to add the rate information for that service from either the System Payor window’s Plan tab or the Master Rates window and select Create Invoices.
Next, select the Create Invoices button.
Select OK to apply any pre-payments, remaining balances, or existing credits. or select Cancel to begin creating the invoice.
Wait for the invoice to complete processing.

Be patient, the system is creating the Invoices. The more visits invoiced, the longer it takes. The progress bar displays the current number of invoices created/total number of invoices queued (percent complete).

When the progress bar reaches 100% and disappears, you are ready to export the claims created using the Export window.

If there is an error message saying that some visits “could not be invoiced” and the reason displays, correct the error, then complete the steps to create an invoice for those visits. Make sure to select Update in the Billing Review screen, before creating invoices.

The visits associated with the new invoice(s), now have a status of 04-Billed. If the Print Invoices Created and/or Print a Summary Report checkboxes were selected they automatically display in PDF format.

Save the Summary Report for your records to reconcile your payment from the Payor.