Patient Clinical Time

Instructions

To view Clinical Time, please click the briefcase icon in the Patient listing under Quick Actions.

You will find an accordion at the top. It can be expanded or closed as needed. By default, the patient details accordion is closed.

Once you click the expand button, you will be able to view the expanded Patient details as follows. On the left, you can also see a call icon next to the Mobile number, which is used to call the patient on his cell.

The Clinical Time tab will appear as shown below.

On the Right Hand side, you will find the Duration Filter, which allows you to filter data by month and provides a custom option as well.

After clicking on that, you will be presented with a date range picker. You will see the current start and end dates shown as the default selections, and you can then choose the date range you need.

After clicking the file, you will receive the records for the specified time period you select.

The pie chart reflects the time spent by the program coordinator and provider on the specified patient dashboard. In addition, the pie chart updates based on the selected filter, which includes both Billable and Non-Billable data.

On the left-hand side of the screen, use the Activity dropdown to filter patient bills. Depending on your selection, additional filtering options may appear:

• All: Displays all generated bills.
• Billable: Displays all billable items. Selecting this opens an additional Service dropdown next to it, allowing you to filter bills by a specific clinical service.
• Non-Billable: Displays all non-billable items. Selecting this also opens the Service dropdown to filter records by service.
• Patient Monitoring: Displays all bills generated specifically under Patient Monitoring activities.

To manually add a billable record under Patient Monitoring, click the + Log Time button on the right-hand side of the screen. Complete the following fields in the pop-up window:

• Service: Select the available clinical service you wish to bill under.
• Activity: Choose either Patient Monitoring or Billing to categorize the time.
• Date: Select the date the service was provided.
• From / To: Input the start and end times for the clinical activity.
• Notes: Enter any relevant clinical or administrative notes regarding the bill.

Click Add to save. The bill will immediately reflect in the corresponding Activity Billing section.

• Non-billable records are automatically generated when you spend time on tabs outside of the core billing services (such as CCM, RPM, TCM, PCM, and AWV). These background records are saved and finalised when you navigate away from the Patient Dashboard back to the Patient Listing page.

Billing — You can view all billing activity. After selecting the billing options under Activity, you will see a new Service Dropdown on the right-hand side. This filter will help you narrow down the records based on the service you selected.

There are multiple ways to add a bill.

1. From Patient Listing.
2. From Operational Reports.
3. From Patient Dashboard.
4. Manual Log Entry From Clinical Time.

1. From Patient Listing:

As shown in the image above, when you select any active service (such as CCM, RPM, TCM, PCM, or AWV) from the patient listing, the following pop-up will appear.

If you select Yes, the timer will begin (billing time will start), and you will be taken to that service in the patient dashboard. If you select No, you will be directed to that specific service in the dashboard without billing.

1.1 Billing Flow:

• If you have selected the CCM service and then clicked Yes to bill the time, you will be taken to the service with the billing timer set to ON. This action will disable the other services, because while you are billing for a specific service, you are not able to navigate to other services such as PCM, TCM, RPM, or AWV.

  

• If you want to stop the billing, you can click on the STOP icon at the top near the header as follows.

  

• Once you STOP the billing, the other services will be enabled, and the bill will be reflected in the clinical time billing activity section.

2. From Operational Reports:

In the Patient tab, you will find the inactive Operational Reports. Please click the Operational Reports tab using the steps below.

From here, we can only bill CCM and RPM. In a record, when we click on the MRN number or Patient Name, you will navigate to that particular patient's dashboard with that service active and follow the steps for billing flow.

3. From Patient Dashboard:

• When you are in any tab other than Services (PCM, TCM, RPM, AWV), and you need to bill for a service, click the Start Billing icon located at the top of the page.
• After clicking the icon, a pop-up will appear with a Dropdown menu that allows you to select the service you would like to be billed for, as follows:

• When you click the Start button, billing will begin for the selected service. Please proceed through the steps in the Billing flow.

3.1 From Service:

If you would like to begin billing while you are in a specific service tab, you may start billing directly by clicking the Start Billing icon at the top and then following the steps in the Billing flow.

• If you want to bill the records that are in the Billing section, then click the checkbox at the beginning of each record.

• You can locate the "Add Bill" button in the top-right corner of the table. Click it to open a pop-up for adding a bill, as shown.
• You can also remove clinical time by selecting the relevant record and then clicking the delete button in the top-right corner of the table.
• You may download the records by clicking the download button located at the top of the table.
• If you would like to download billable records, enable the billable toggle and then click download.

• Service - The service name will be pre-populated based on the record you selected in Billing.

  Note: If you select multiple records with different services, the entry will be categorized as "others."

• CPT code - Select the CPT code based on the billing type.

• Description - Based on the CPT code, you will receive a set of descriptors from which you can choose.

  Note: If the desired descriptor is not available, scroll to the bottom of the dropdown, select the other option, and enter your desired descriptor.

• Provider - The provider’s name will be pre-populated based on the record you selected in Billing.
• Patient - The patient’s name will be pre-populated based on the record you selected in Billing.
• From Date - This will be pre-populated, and the date and time will be based on the oldest record selected.
• To Date - This will be pre-populated, and the date and time will be based on the newest record selected.
• Notes - Add a note that is related to the billing.

• Call Type - This will be pre-populated when you select the CPT code. It is also editable.

  After clicking Add, the billed records will be disabled. The bill will then appear in the Billing tab.

To submit the bill, click on the Bills Tab to navigate to the Bills section.

• When you navigate to the Bills tab, select the service type in which you added the bill from clinical time.

  Note: If you have added a bill with services other than clinical time, please select the 'Others' tab in the service section of the billing.

• Billing Period -  will be pre-populated for the last month. You may change it as needed.
• Click the RPM, CCM, TCM, or Others tab to display the calls list. Each row will include a checkbox along with the following details:
  • CPT code
  • Time
  • From (Date & Time)
  • To (Date & Time)
  • Topic
  • Summary
  • Status
  • Action
• CPT codes vary by service type, including RPM, CCM, TCM, and Others. CPT codes for all reimbursement types are different.
• You can set the Billing Period by selecting the Month or Quarter.  By default the selected month will be previous month.

• Click on the CCM tab.

  

• Users can use the “Add  Claim” option to add a new claim to the provided list by entering the required details, including Service, CPT Code, Description, Provider(Auto-Generated), Patient (Auto-Generated), Month(Auto-Generated), Notes and Call Type.

  

• To edit the call details, click the Edit icon under Action. This allows the user to update the details for the selected Claim in the list, including the Service, CPT Code, Description, Provider, Patient, Month, Notes and Call Type.

  

• Users can select the claim from the list and click Submit. The claim will also be automatically submitted if the appropriate amount of time has passed for that service and its corresponding CTP code.

  

• The submitted bills cannot be edited.

  

• Each reimbursement type tab has filters, as shown:
• All - Displays all CCM call logs.
• New - Shows all newly submitted calls/bills, represented in blue.
• Submitted - Shows all submitted calls/bills, represented in light green.
• Rejected - Displays all rejected calls, represented in red.
• On-Hold - Displays calls that are currently on hold, represented in amber.
• Approved - Displays all approved calls, represented in green.
1. In the Action column, users can view two options: Edit and Delete. The Edit and Delete icons are enabled for all New and Rejected bills.
2. After a bill is submitted, or when it is kept on hold and then approved, the Edit and Delete icons will be disabled.

3. When a user clicks a Rejected call/bill, the user can review the rejected reasons. The details include the rejection date along with the corresponding rejected reason.

   
   

• When you click the download icon, you will be able to access the Summary of the CCM Episode. In addition, you may download the document by selecting the floating download button, or use the print button to generate a PDF for printing.

• We can also download the each bill document by clicking on the download icon.
• We can also download the bulk bill document by clicking on the Download Supporting Documents Button.

Approve Time:

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• The call logs that are submitted are saved in the Billing Portal. Once the Admin logs in, they can view the screen shown below.
• By default, All Programs and All Providers are selected. You may adjust these options based on your preferences.

• On the dashboard, count for Patients enrolled, Patients billed, Bills accepted, Bills pending will be displayed.

• On the left-hand side, there is a table icon. Upon clicking on it, a pop-up will appear where you can select the required table columns, as shown below.

  

  

  
  
  1. There are 9 filters: Network, Center, Service, Provider, Claims Status, Payment Status, CTP Code, Duration, and Search Bills, which allow you to search bills for review.
  2. Users can filter the submitted billing list based on the bill status across four categories.
     • Submitted Bills
     • Bills on Hold
     • Accepted Bills
     • Rejected Bills
  3. Patients that qualify under the rules engine for the set of rules associated with the respective CPT code will be ready to be billed, while patients that do not qualify under those rules will be rejected by the rules engine.
  4. Users can also filter the submitted billing list based on the type of billing or product (All/RPM/CCM/RTM/TCM/PMPM).
  5. Click the Status filter, select the Submitted Bill option, then click the Program filter and select CCM. The following screen will be displayed.

• User can filter the submitted billing list based on the selected duration of Date from and Date to. We can view the bills based on the Duration type - Monthly, Quarterly & Custom. By default, we have Monthly selected.

  

• Users can filter the submitted billing list by provider name for the selected center.
• The search field is available on the dashboard to find the required data.
• Below the filters, the table is displayed with the following headers:
  • Checkbox — to select all records
  • Patient EMR ID
  • Patient Name
  • Date of Service — the date on which the service was provided
  • CPT Type — RPM/CCM/TCM/Other CPT code and topic
  • Note — meeting notes captured while scheduling
  • Provider Name
  • Bill details — Bill ID and the month, date, and year the billing was submitted
  • Actions — Approve / On Hold / Reject
• All submitted bills appear in the list in checkbox form. Users can select bulk actions to mark the selected bills as Approved or Rejected. Users can also download the bills by clicking the Download option.
• To submit the bills, select the checkbox and click Accept selected bills on the right. A pop-up will appear to confirm whether you want to accept the bill. Click Yes to accept the bill.

• You can also reject bulk bills by selecting the relevant records and clicking the "Reject selected claims" button. This button will be displayed in the header area once you select the bills. After you click the button, a pop-up window will appear prompting you to enter the reason for the rejection. Once you enter the reason, click Submit. The rejected bills will then be listed under Rejected Bills.

  
  

  

  
  

• You may perform actions—Approve, On Hold, or Reject—for individual calls. After the call log is approved, set to On Hold, or rejected, it will be categorized as Accepted, On Hold, or Rejected, respectively.

  

• If there are no calls logs, you will see an empty state showing No records found.

  

  
  
• Once the bills are accepted, you can view them by selecting Status as Accepted.
• To download the Bill report, select the checkbox for an individual record, or select the checkbox in the header to download the report for all records.
• You can download the report for any status, including All, Ready to bill, Submitted, On-Hold, Rejected, and Approved.

• You can view download option at the right, click on the download to download the report. You can view it in your downloads.

• We can also add the Billed Amount, Allowed Amount, Adjusted Amount, Balance Amount for each bill in the input field where you can enter the amount and click outside the field. It will be saved, but it is only for reference and will not be referenced anywhere else.

  

• We also provide the options Claim Denied, Claim Failed, Closed, Patient Pending, Secondary Pending, and Claims On Hold to update the payment status of each claim. To access these options, please select the submitted claim status and click the more icon, as shown in the image below.

• We also have the option to upload the billing reconciliation file. You can upload an Excel file with the claims data of each patient and check the history of the uploaded file. Additionally, you can download a sample file or sample reconciliation template by clicking on the "Download Reconciliation Template" button.