So often, a patient is entered into the system under a particular status, charges are accumulated for weeks or months and then it is determined that these charges should be billed to a different third party. To accomplish this rebilling process manually would entail many man hours. This time consuming task is eliminated by this pharmacy system function - Retroactive Rebilling.
The system allows you to rebill ANY billing transactions for ANY time period from one third party to another. All or selected prescriptions may be rebilled. Multiple cut-off dates can be entered for each new third party.
By selecting the patient, entering the "from" and "through" dates to rebill plus the new third party code, all prior transactions will be credited to the patient's account and new charges will be generated for the current status. If copays are required for the new status, the system will pause and allow the entry of the copay amount. If the OLD third party charged a copay, this amount is reversed. If prior authorization is required for the NEW third party or the drug is not covered, you are alerted and can enter the appropriate response.
When applicable, the current billing statement will reflect the credit issued in the form of "REBILLED TO MEDICAID", etc. The newly generated charge will reflect "REBILLED FROM MEDICAID", etc. The accounts receivable file is automatically updated.
If the "rebilled to" third party can be adjudicated electronically, the transaction is added to the ON-LINE BATCH BILLING pending file.
Billing transactions for any time period can be displayed on the video. These charges are grouped by status and include totals for each third party.
A hard copy report of all rebilled transactions is available to aid in the A/R reconciliation process.
Copyright © 2008 Prodigy Data Systems, Inc.