Eligibility can be confusing. It is recommended to complete eligibility checks through your payer or clearinghouse often. Sometimes medical and behavioral benefits are different so it is important to ensure that you are billing the correct payer and payer ID or claims will be denied.
If you discover that you have billed the wrong payer, there is a multi-step process by which this can be corrected within Aloha. The steps must be completed in this order since they build upon each other.
During the first part of the process, it is important to make the system believe that these appointments have not been paid for or billed for. Once an appointment is run through Payroll or billed out in Aloha, it cannot be changed.
Release the Claim: Billing > AR Manager > Double click on Payer (it's the wrong payer) and select the claim you billed out incorrectly. Go to "More" and select "release". This makes Aloha think the claim has not been billed.
With the release of 2.18.1, you no longer need to revert Payroll and Timesheets when making billing-only edits to a claim. However, if you’re adjusting the time, you’ll still need to revert Payroll and Timesheets since the change will impact payroll calculations.
Now you are able to edit the appointments, let's get the correct information in the system.
Add correct Payer and Authorization to each client profile: Staff/Client/Payer Management. Make sure you are billing under the correct Payer ID.
Uncomplete every appointment that has the wrong payer attached. Edit the Appointment --> Verification Tab --> Uncheck "Completed" box.
Double click on the Client/Service/Auth from Appointment Info Tab. All authorized services and payers will pop up.
Select the service with the correct Payer.
Recomplete the appointment: Verification Tab --> Check "Completed" box.
SAVE
Repeat for all appointments that were billed to the wrong payer.
In order to ensure that this error doesn't occur again, make sure to remove all extraneous information.
Delete the old authorization from the client profile: this can only be done after all appointments are switched over.
Delete the payer from the client profile: can only be done once the auth is deleted
If you cannot delete the authorization or payer, it is recommended to change the authorization to unschedulable. Within the authorization, go to the "schedulable" dropdown for each service and select "no"
Now that everything in the system is correct, you need to Rebill all appointments under correct payer: Billing
Don't hesitate to reach out to your Customer Success Manager with any questions.
