The Insurance Company Database is a key component of your CPR+ system. When the Insurance Company Database is set up correctly, your company can seamlessly bill according to individual payor conventions for services rendered.

The Insurance Company Database now features the split screen format that was introduced in v8.0a last Fall. To select an insurance company from the grid, just click on the Edit (F4) button, and the “old school” Add/Modify Insurance Company screen that you are used to seeing will appear.

The Add/Modify Insurance Company screen also provides access to the General/Billing Info tab, the 1500 Options tab, the Notes tab, the Setup Options tab, and the Alt. Billing Addresses tab. From the bottom of the screen, you will also have access to the F1 Help screen, the Special Price Matrix, and the Electronic Setup Information (if activated by the appropriate Invoice Type). From this screen you can also delete the Insurance Company, although an Insurance Company cannot be deleted if it is assigned to a patient. The “Insurance Company Inactive” checkbox is a better option to select. This will remove that specific Insurance Company from every selection grid except for the Insurance Company database itself.

Let’s take a minute to explore each tab.

The General / Billing Info tab (shown above) is where you will enter the general information about this specific payor. A few quick tips for this tab would include the following:

• If the Primary Billing Address information is the same as the General information, just tab through and the Organization, Address, City/State/Zip Code, and Contact will be copied from the General information.
• Also, remember that the “Requires Invoice Type” field is going to determine which type of invoice is created when billing and will also drive what information needs to be entered in the Insurance Company Setup.

The 1500 Options tab is going to set up how CMS or HCFA 1500’s are printed from CPR+. You will notice that the options on this tab will change depending on whether CMS or HCFA 1500 is selected in the “Requires Invoice Type” field on the General / Billing Info tab. Also, if at any point in time, a WebMD Medical or Medicare Electronic claim needs to be printed, set the “Requires Invoice Type” field to CMS 1500, and then set the options for the printed claim. Now, the “Requires Invoice Type” field can be set back to the appropriate electronic payor.

The Notes tab is where to enter any notes for this insurance company. These notes are for internal use only and will not be printed on any forms or transmitted in any claims. The Notes can be viewed when creating an invoice and from the A/R Manager or the Notes Manager.

The Setup Options tab determines how Delivery Tickets, Line Items, and Pricing are handled for this payor. Also, Authorization and Documentation requirements can be set here. If you haven’t looked at this portion of the Insurance Company database for a while, take a minute to look at all of the options available.

And last, but not least, is the Alt. Billing Addresses tab. Alternate billing addresses are used for payors with multiple billing addresses, but are otherwise exactly the same.

As you can see, taking some time to re-evaluate the valuable information that is stored in the Insurance Company database can really make a difference in your bottom line. To learn more, please review the On-Demand Training class IDM020 – Insurance, SPM’s, and Shared Contracts.

This topic will be covered in the Pre-Conference CPR+ Fundamentals Session, October 3rd. You can also contact the Training Department by phone or email at (877) 277-4876 or training@cprplus.com.

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Here’s a good question: What is the most convoluted set of billing rules in home health care? The Medicare rules for billing rental items are at the top of my list. Is it a capped rental item or just treated like a capped rental item? When is the item converted to a sale? Do the numbers 2, 4, 10, 13, 15, 22 or 36 have any meaning to you?

I can tell you this, they are not the Fibonacci sequence. For the answers to these and other questions, we will be including a class on Recurring Rentals Management during this year’s User Conference.

This class is designed to review all of the Medicare policy functionality built into the Recurring Rentals Manager, as well as to review the process for editing items, creating multiple line items and creating claims. Additionally, we will review the Recurring Rental auto-creation process.

Did you know that version 8.1a of CPR+ will include an exchange ticket? This class will cover how the exchange ticket updates the Recurring Rental record. In addition, Pickup Tickets and Stop Dates will be covered in this class.

During this session, you'll learn how to do the following:

• Set Program Options and Insurance Company options to correctly prompt for and generate Recurring Rental billing.
• Set sorting and filter options in the Recurring Rentals Manager.
• Set up an item for recurring billing.
• Create Recurring Rental claims.

If you are looking to brush up on Recurring Rentals or learn how to get the most out of your Recurring Rentals and Recurring Rentals Manager in CPR+, then this is the class for you. Join us at the 2008 User Conference and get the most out of your CPR+ experience!

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