Getting Ready to Bill

1. It is recommended to bill one payer at a time (e.g, BCBS CA)
   
2. Set your parameters with your payer and date range
   
3. Hit Generate and all the appointments from that payer in that date range will populate
   
4. Scroll to the right and view the Completed column.  If you see a "Yes", this appointment is ready to bill.  If it is blank, the appointment has not been completed/verified.  Go back to the schedule and go to the Verification Tab and check the box that says "Completed".
   

All appointments, whether completed or not, will appear in this report.  If you skip this step and go straight to the Billing Manager, uncompleted appointments will not appear.  

Once all of the appointments for your desired date range have been completed, you are ready to bill.  To access any of the features below simply click the  icon on the left navigation menu.

Billing Manager

Processing Billing

1. Select a date range and payer to find your billable appointments and click Generate.
2. You can sort and filter the appointments using the Search field at the top or sort at the top of each column.
   
3. All appointments with a GREEN box are ready to bill.
   
4. All appointments with an ORANGE box contain a validation error.
   
1. You can view the validation error by hovering over the  icon.  
   
2. In most cases you can simply fix the error on the same screen by locating the column which has the missing or incorrect information. After fixing the validation warning the orange checkbox will change to green and your all set!
   
3. If multiple appointments have the same fix, you can select them all and perform a "bulk update" to fix them all at the same time.
5. Scan across your appointments to ensure there is no important information missing (e.g., modifiers)
   
6. Select the appointments you would like to bill. You can select all ready to bill appointments by clicking the the checkbox in the header . 
   
7. After confirming that you have selected all ready to bill appointments click Process Billing at the top right of your screen.
   
8. For insurance appointments, this will create a CMS 1500 form that will go to the clearinghouse (if connected).  Review this form and click Process Billing again to send to the clearing house.
   
1. If your clearing house is not connected to the Payer, your claim will not go anywhere and just be considered "billed" in Aloha.

Customizing Billing Manager Columns

1. Click   on the top right of the screen.
   
2. Settings
   
1. Freeze Columns - Freezes the # of columns on the left. These columns will always be view-able.
   
2. Max Appointments per page - How many appointments to show on the same page.
   
3. Managing Columns - Customize what columns to see on the Billing Manager screen.

Accounts Receivable

Navigating through AR Manager

Smart Actions

Smart Actions will be available after selecting one or more claims/charges.

1. Transfer
   
1. Will automatically transfer the claim to the secondary insurance indicated when setting up authorizations. If the secondary insurance is not available the Transfer option will not be available. 
   
2. More:  You will be able classify the claim to the following with the More option.
1. Rejected:  A rejection means there is a clerical error on the claim and it was not able to be viewed because of this (e.g, wrong payer ID).  Most often in this scenario you will use the release option.
   
2. Denied:  Mark a claim as denied when the insurance company has refused to pay a claim and given you a remit with a reason code. This is different than a rejection.  A reason code will be required and can be found on the ERA/remit.
   
3. Release:  Complete this option when you need to make changes to an appointment or claim.  This will make the Aloha system think the claim has not yet been billed.  An example might be if you need to change the number of units billed.  When you are ready to bill it again, go back to the Billing Manager.  Releasing a claim only releases it in Aloha, not in a clearing house.
   
4. Settle:  The payer has not paid you the amount that was contracted, but you are not going to continue to engage in negotiations.  This will mark the balance as zero.
   
5. View invoice/claims:  View your CMS 1500 form again
   

Secondary Billing

Fix Claim

1. Select the claim(s) to be fixed.
   
2. Click Fix Claim.

3. Complete the necessary fields to update here, just like how you would on the CMS1500 form.  
   

1. In the Submission information window: 
   

1. Resubmission code is equivalent to box 22 (7 for replacement of claim, 8 for voiding a claim) 
   

2. Original reference no (the claim number assigned by the payer) is equivalent to box 22  
   

3. Additional claim information is equivalent to box 19  
   

2. Update the changes you need to the claim itself for the denial reason (e.g. update units, auth number, etc.)  
   

4. Click “Ready to Bill” when done.  
   

1. On the left hand side in Billing, go to “Rebill” 
   

2. Any claims that were ready to bill are now sitting in Rebill. Select the claim and process billing just like how you would in the Billing Manager and click Process Billing 
   

3. Your claim has now been sent off to clearing house and resubmitted.

Verification Forms

1. Payer:  Select a payer to generate a verification form.
   
2. Verification Format: Select which verification form to generate (DDS Parental Verification/DDS with Service type/ Parental Verification).
   
3. From / To Date: Date range for appointments.
   
4. Client(s): Select the clients to show on the verification form.
   
5. Appointment State: What type of appointments to display (All/Signed/Completed) on the verification form.
   
6. Click Generate and download if desired.
   

FAQ Billing