Billing
Paper claims and claim forms
Print CMS-1500 claims on plain paper or pre-printed red forms, record the mailed date, align your printer, and set billing defaults such as partial online payments.
NeatPractice prints claims on the standard CMS-1500 (02/12) form. The same claim data feeds the form and the electronic claim, so what you print matches what would be sent.
Print a claim for mailing#
- Scrub the claim until it is Scrubbed.
- Open it and choose Print Claim. NeatPractice downloads the PDF and the claim moves to Printed.
- After you mail it, choose Record Mailed Date and pick the day it went out (today is filled in, so you can save it as is). Timely filing counts from it.
A claim with more than six lines continues on more pages; the total charge is on the last page. Each print is a paper batch in Claim batches.
Plain paper or red forms#
Each payer's setup says whether its claims print on plain paper (the whole form, the default) or on pre-printed red forms (only the data, placed for the form's boxes).
To see a claim's form without printing it for mailing, choose Preview CMS-1500 in the claim's header menu. The preview does not change the claim.
Rendering provider default#
Payers whose rule set says Clinic default for Bill under follow the clinic's choice. Open Setup, then Claim Forms, pick Bill under in Rendering provider and choose Save Default. See Supervised and concurrent services.
QA approval hold#
On the same page, QA approval holds charges for every payer while their note waits in the QA queue. Turn on Hold charges until QA approves the note and choose Save QA Approval. See Charges waiting for QA.
Missed-visit fees#
Missed-visit fees on the same page set what a patient owes for a Late cancel fee ($) and a No-show fee ($). Leave one blank to charge no fee of that kind, then choose Save Fees. See Missed-visit fees.
Travel rates#
Travel rates set what a finalized visit's drive time and miles bill to self-pay patients and school or agency payers: Drive time ($ per hour) and Mileage ($ per mile). Choose Save Rates. See Travel charges.
Claim follow-up#
Claim follow-up sets how many days a sent or mailed claim can go without a payer answer before it joins the No response list: Follow up after (days), 30 by default. Choose Save Follow-up. See Claim follow-up.
Partial online payments#
Partial online payments decide whether a patient or family paying a statement balance online may pay only part of it. Turn on Allow partial online payments, then set the least such a payment takes:
- Minimum payment ($): a fixed amount, such as
25. - Minimum of the balance (%): a share of the balance, such as
10.
When you set both, the larger one applies, and the minimum is never more than the balance itself. Leave both blank to accept any amount. Choose Save Partial Payments. With the switch off, an online payment covers the whole balance. A partial payment applies to the patient's oldest dates of service first, like any patient payment applied to the oldest balance.
Line up red forms#
If your printer puts the data off the red form's boxes, open Setup, then Claim Forms, and move it right or down in hundredths of an inch (a negative number moves it left or up). Choose Save Alignment. Plain paper forms never shift.
What goes in each box#
| Box | Comes from |
|---|---|
| 1, 1a, 4, 7, 11 | The payer type and the coverage's subscriber, member id, group and plan |
| 2, 3, 5, 6 | The patient and the relationship to the subscriber |
| 9, 9a, 9d, 11d | The patient's other coverage on the dates of service |
| 12, 13 | Signature on file when the release of information and assignment of benefits are on file |
| 17, 17b | The episode's referring provider, or the ordering provider when there is no referring one |
| 19 | The claim's Box 19 text |
| 21 | The claim's diagnoses (up to twelve) |
| 22 | The frequency code and the payer's original claim number on a replacement or void claim |
| 23 | The authorization number |
| 24A to 24J | The charges: dates, place of service, code and modifiers, pointers, amount, units, EPSDT or family planning, and the rendering provider's NPI with a payer-specific number or taxonomy |
| 25, 33, 33a, 33b | The billing provider: the practice, or the location's own billing identity, with a payer-specific number or taxonomy |
| 26 | The patient's chart number |
| 27 | The payer's accept assignment setting |
| 31 | The rendering provider's name and credentials |
| 32, 32a | The location, or the patient's service address when the visit happened there |