Billing Overview

The Billing functionality at HHAeXchange is comprised of two internal auditing processes which ensures:

  • Visit information is accurate before it is invoiced.

  • Invoices contain the proper export requirements before sending to the Payer.

If the billing data satisfies export requirements on the auditing or Exception pages, invoices may be exported as an E-Billing Claim or Paper Invoice. The flowchart below provides a high-level view of this process. Exception pages are highlighted in orange:

Prebilling and Billing Process Flowchart

Term

Definition

Patient

Refers to the Member, Consumer, or Recipient. The Patient is the person receiving services.

Caregiver

Refers to the Aide, Homecare Aide, Homecare Worker, or Worker. The Caregiver is the person providing services.

Provider

Refers to the Agency or organization coordinating services.

Payer

Refers to the Managed Care Organization (MCO), Contract, or HHS. The Payer is the organization placing Patients with Providers.