ZH Advanced Billing Module for OpenEMR

The Advanced Billing module is focused on providing capabilities to manage and improve your revenue cycle by decreasing staff time needed to enter billing, process and manage insurance claims, record payments; improve the accuracy of coding of encounters; provide quick access to patient accounts for responding to inquiries and resolving status of claims.

Enhanced Billing and Claims Processing

Smart Fee Sheet

Easy to use template that looks like the paper super-bill you are used to
Store CPT, ICD valid codes for easy and correct entry
Allows for multiple fee sheets for a single facility
Allows advanced capability to lock encounters that are not ready for billing
Time saving ability to enter miscellaneous options without leaving the fee sheet

Batch Charge Entry to Support Larger Facilities

Ability to enter multiple claims from a single screen
Allows for entry of new patients from the same screen
Real Time Eligibility Verification for Insurance

Billing Management

Work on all claims from a single screen
Advanced filters to see only the claims you are interested in working
Allows to view fee sheet and demographics ledger
Ability to fix all errors before submittal increasing First Pass Rate
Data entry uses quality control verifying codes as you type and automatically applies relevant data (patient, provider, payer) from system database
Generate HCFA, PDF, TXT, or Electronic Claims files
Automatically generate and upload claims to clearing house
Option to direct claims to 3rd party billing systems
Supports multiple insurance company networks
Ability to process secondary insurance claims
Ability to write off balances
Allows for moving balances to patient accounts
Ability to send more than 4 diagnosis with claim

Clearing House Integration

Seamless integration avoiding steps to generate and upload files separately
Advanced import facility will import NPI and Tax ID numbers needed for posting payment from ERA
Enhanced file summary of uploaded claims to clearing house includes current status of the claims and response from the payer allowing ability to update the EMR database automatically

Rejected Claim Management

Enhanced query ability to enable quick review to remedy errors and re-file claims from a sign screen
Stores history relating to why the claims were denied

Advanced Payment Receipt Processing


Easy entry of payments and adjustments
Single screen to receive any payment method including cash, check, credit card
Advanced search and filtering to view only the payments you wish to review
Allows receipt from any type of payment source including advance payment, group payment, capitation payment, insurance payment
Easily allocate payment or EOBs to specific encounters
Easily allocate payment to specific CPTs within a claim and track unpaid CPTs within a claim
Ability to enter payments to specific "post to" dates
Easily enter data from EOBs and apply insurance company responses to patient accounts
View and print original EOBs and other payment documents

ERA  Posting

Post individual ERA and automatically update to patient accounts
Advanced ability to batch process ERA files from multiple insurance companies greatly reducing process time for larger facilities

Capitation Payments

Ability to enter and track capitation payments
Analysis reporting for profitability of capitated patient encounters

Accounts Receivable Management

Full featured claims and action tracking allowing to monitor and report on claim status, alert for follow ups, and identify payer denied claims
Supports claims appeal process to determine reason for denial, collection of needed additional information and resubmission of claim
Maintains call log of follow up actions

Patient Accounts

Pre-Authorization Management

Ability to enter pre-authorization and plan details greatly reducing staff time needed to manage the variations of authorized treatment
Track encounters based on number of visits, hours, specific CPTs
Flag encounters where pre-authorization is not covered or reaches allowed coverage

Patient Ledger

Elaborate patient ledger displaying total charges, amounts pending for each insurance, payments received, balance details detailing insurance versus patient portion
Color coded line items to easily distinguish services, patient payments, insurance payments, and adjustments
One click viewing of underlying fee sheet or payment
Quick printing directly from ledger of individual patient statement and patient ledger

Patient Statements

Batch or individual printing of billing statements
Quick access to billing statement and payment history from patient profile
Easy billing lookup for responding to patient billing inquiries

Advanced Reporting

Library of reports to track accounts receivable, patients, and other financial information
Ability to customize reports to needs
Reporting memory option allowing specific filter and reporting queries to be saved for repeated use
Export reports to PDF, Excel or CSV formats

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