Maternity Neighborhood Billing from Start to End

Who is this guide for:
Account Owner or Practice Manager

Where to begin:
Practice Settings

The Billing tool is intended to assist with in-house billing and to create super-bill documents for use by an external biller or billing service.

This guide will take you through the necessary steps for Billing an encounter from start to finish, here's what we'll cover:

1. How to Add/Edit a Fee Schedule for Your Practice
2. How to Code an Encounter
3. Understanding the Client Billing Tab

How to Add/Edit a Fee Schedule for Your Practice:

Our Fee Schedule is pre-populated with a list of the most common procedure codes used in maternity care. Users also have the option to add custom codes to the Fee Schedule.

To start, click Settings in the left hand navigation bar. This will take you to the practice settings where you can click on the Billing tile.

You'll then land on the Fee Schedule where you can Add/Edit fee amounts to pre-populated codes or create custom codes of your own - all of which you'll be able to add to encounters. For our guide on how to add custom codes, click here. 

Codes added in the Fee Schedule become available for all users who have permission to update client profiles and bill encounters.

How to Code an Encounter:

You've set up your Fee Schedule and have begun posting encounters. You're now ready to code individual encounters with procedure and diagnostic codes. 

Start by clicking into a client with posted encounters, then select the encounter you'd like to code. Once you are within the encounter you'll see Services and/or $ in the right hand side. 

Once Services or $ is selected, a pop-up will appear (if there are any progress notes on the encounter they'll appear at the top). Click on +Add procedure, service or supply to begin.

The search function allows you to pull a code from the Fee Schedule (whether a pre-populated code or a custom one you've added). Start by entering at least three digits of the code number or typing the name of the procedure type.

The diagnosis field allows you to add diagnosis codes, which are in ICD-10 format. Fo those on our Midwife product, if there are codes listed in the Problems or Allergies tiles in the Problems tab, you'll see them appear once you click the dropdown.

If there are no codes appearing or you'd like to pull in a code you do no see, click Search for diagnosis. Enter at least three characters of the phrase or ICD-10 code. For example, if you need the diagnosis code for prolonged labor, you can type in long labor, stalled labor or any other descriptive term and retrieve the appropriated code for billing.

In order to save the procedure codes, all mandatory fields must be field out. The asterisk (*) denote that a field is mandatory. You can add multiple procedure codes by clicking on  +Add procedure, service or supply.

Once it is filled out to your satisfaction, click save.

Understanding the Client Billing Tab:

The Client Billing Tab is where you'll find all of your coded encounters and can take action to file them as claims. It's broken down into four sections:  Insurance, Services, Claims, and Payment. 

Insurance

In order to file a claim the client must have insurance on file. 

If the client's insurance information was previously filled out in the Intake Form (found in the Forms section) then the system will auto-populate the information once you click +Add insurance. 

If the client's insurance was not previously filled out then once you click +Add insurance a pop up will appear for you to fill out the client's insurance information. Any field with an asterisk (*) is required. 

On this page, you can also upload files relating to billing, such as a picture of the client's insurance card. Just click upload file, and you'll be able to view your uploaded file here or under the Files section.

Once you've added the client's insurance, you'll then have the option to Verify Benefits. Maternity Neighborhood cannot verify the client's insurance electronically as we do not have a clearinghouse, but once you've confirmed the insurance you are able to manually enter information about deductibles, out-of-pocket max, copay, and more. 

Clients cannot view this tab.

Services

All coded encounters will be listed here and will either fall under the Unbilled or Billed sections. To move a Unbilled services to the Billed section, click on the Generate Claims button. This will move the service to the Claims tab.

The Add global procedure button will appear once you've added a billable procedure on at least one encounter. 

Client's cannot view this tab.

Claims

All generated claims will appear here, and you can manually track the progress of a claim from this tab. As the claim moves through the process you can updated the Claim Status by selecting the dropdown next to the claim you'd like to update. You'll have the option to select Unsent, Sent, Accepted, or Rejected. 

Once the Claim Status is updated to Accepted, you'll then have a dropdown for the Payment Status and can select Processing, Denied, or Paid. 

Once Payment Status equals Paid, a popup will appear for you to enter the date and the amount paid. The amount paid will now appear in the payment ledger under the payments tab.

Client's cannot view this tab.

Printing out a Superbill

Should you need an itemized form detailing the services provided to a patient for reimbursement, the Claims Tab is where you'll find it. You can print out a Superbill by selecting one of the listed claims. A popup will appear. On the top/bottom right corner click on Export and select Print. 

Payments

The Payments tab is a payment ledger which lists all charges and payments entered by users, as well as any adjustments of the balance owed. 

You can add a new Charge, Payment, or Adjustment directly from this tab. Adding a Charge will increase the balance owed. While adding a Payment or Adjustment will decrease the balance owed.

Should you need to include addition details, click Add Note. Notes can be made visible to the patient (check the box) but are kept private as default.

This tab is visible but not editable to the client and will list the payment history from all episodes of care on the client's chart.