HHAeXchange Lunch-and-Learn Webinar …...HHAeXchange Lunch-and -Learn Webinar Rebilling in HHAeXchange The content contained herein (“Confidential Information”) is the confidential

HHAeXchange Lunch-and-Learn WebinarRebilling in HHAeXchange

The content contained herein (“Confidential Information”) is the confidential property of HHAeXchange and may not be copied or distributed without the express written consent of HHAeXchange. Distribution of this document or disclosure of any Confidential Information set forth herein to any party other than the intended recipient(s) of this

presentation is expressly prohibited.

Agenda

• Review the current challenges • Review the new Rebilling Module• Review the processes and workflow of Rebilling• Review the most common causes for Rebilling

Current Challenges

Process• Submit a spreadsheet via ticket to support with the shifts to Rebill • Submit a ticket to support with shifts to void and delete• Submit a spreadsheet via ticket with corrected hours to Rebill

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Solution: Rebilling Module

Rebilling Module Benefits

• The Rebilling Module allows you to resubmit a claim without having to submit a request to the HHAeXchange Support Team.

• Better control over who, what, and when a resubmission occurs.

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Where Do I Go to Resubmit?

2 New Menu items have been added to support this feature under the Billing Tab(Billing > Electronic Billing)• Resumbit Claims• Batch SearchThe Rebilling Module will allow you to resubmit Adjustment and Void claims

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Steps for Rebilling1. Select the Payer from the

Payer field (required) 2. Select Add Claims3. Use filters to search for claims

Steps for Rebilling (Cont’d.)4. Click the Pencil icon ( ) to access the Claim Adjustment screen

5. Select Submission Type (Adjustment or Void) 6. Update and Save the Adjustment/Void7. Click the Export and Download button on the Resubmit Claims

screen

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When is Rebilling Necessary?

Adjustment / Void

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Adjustment

• Also referred to as a “Corrected Claim”

• Used when the Provider wants to make a correction from the original claim

• Requires a TRN

Void

• Used when the Provider want to negate (void) the original claim entirely

• Must be submitted as an original claim after the void is submitted.

• Requires a TRN

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NOTE: If you have billing questions and are unsure whether to select adjustment or void, please contact your Payer (MCO) for additional assistance.

TRN: Required when Rebilling

The TRN is the Payer’s TRANSACTION REFERENCE NUMBER

It can be referred to as many different names.

EXAMPLES:• Form Number • Claim ID• Claim Number

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Where is the TRN located?

• Imported with the Electronic Remittance Advice (ERA)• Can be found on the paper remittance• Payer portal• Contacting the Payer (MCO)

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Most Common Reasons for Rebilling

Reason #1: Split Shifts

• Split shifts are the most common reason for rebilling(often due to late time sheets)

• In these cases:• 1st Shift has been billed • 2nd Shift (same day) is entered into HHAeXchange after st Shift already billed

• Result: The 2nd Shift is held in Billing Review for Pending additional Shift

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Reason #2: Billing to the Wrong Payer/MCO

Steps to Address (VOID)• Send a void claim to that wrong payer• Delete the shift(s) from the Patient• Rebill an original claim with the correct Payer

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Reason #3: Need to Update Visit Information

ADJUSTMENT• Change of hours• Units • Rate• Export Code/Procedure Code

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