Invoicing Guidelines

This topic provides guidance on understanding Invoice logic in the HHAeXchange system and how it affects claims. Herein, are guidelines to resubmitting claims as well as the steps to Un-bill and Rebill.

Every time the Invoice Batch button is clicked, the system generates one or more unique Invoice Numbers that are assigned to the visits selected on this page. For scenarios where there are more than one visit per day, the system only groups these visits if they are selected at the same time. Failing to do this can result in these visits getting held in Billing Review for Pending billing of additional shifts on same day or Visits on same day/service code must be billed on same invoice.

Billing New Invoice Batch Invoice Batch Functionality

Same day/Service Code visits that are billed with different Invoice Numbers are held in Billing Review for the first day, but the system’s overnight process corrects all these cases automatically and assigns a new merged Invoice Number. This merged Invoice Number is only visible on the Export File, and the invoices listed on the visit appear the same.

Consider the following when submitting an adjustment claim:

  1. If multiple visits are billed under one Invoice Number, then ALL those visits should be included on the adjustment claim even if no corrections are needed for the rest.

  2. Ensure to use the original TRN Number that was assigned by the Payer with only the corresponding visits. The Payer reverses the original amount and pay the new corrected amount.

If a payment has been applied to the visit, then the visit must be disassociated from the check. Complete the steps below to unbill a visit.

  1. Go to Billing > Cash Payment to locate the check. When found, un-post the check and unselect the visits that need to be re-billed. Click Save.

  2. Go to Billing > Search > Search by Invoice to find the Invoice associated with the visit to un-export the visit. Click the Invoice Number link to open the Invoice Details page.

  3. The Invoice Details page opens. Click the Y link under the Export Status column to change the Export Status.

  4. The Update Export Flag to No window opens. Enter the TRN Number sent with ERA by the Payer. Select the Place On Hold checkbox to prevent the Visit from being automatically exported until all other steps are completed. Select the Manual Hold Reason from the dropdown and click Save.

    The visit and associated TRN is found in the Remittance File.

  5. On the Invoice Details page, the Export Status changes to N (No) and the visit is placed on Hold. Click the Delete Delete Icon Icon to delete the visit and Invoice records.

  6. Select Remove Visit from Invoice.

  7. The Visit Delete pop-up window appears. Select a Reason from the required field. Click Delete to finalize.

Once un-billed, the visit can be rebilled. Follow the steps below to rebill the visit.

  1. Go to Billing > New Invoice Batch. Conduct a search using the Payer and Patient.

  2. Select the visit to bill and click the Invoice Batch button. Both visits are now billed and ready to export.

  3. On the Batch Details page, click the Patient Name link to access the Patient Profile/Calendar.

  4. On the Patient’s Calendar, click the “V:” link on visit.

  5. Select the Bill Info tab and enter the TRN Number. Click Save.

  6. Once complete, the system generates an 837 Adjustment File and exports the visit/claim via the nightly process (overnight). To view, go to Admin > File Processing.