Patient Clinical Time

Instructions

1. To view Clinical Time, click on the brief case icon in the Patient's listing - Quick Actions.

2. You will see an accordion on top, it can be expanded and closed when needed. By default, the patient details accordion will be closed.

3. And, once when clicked on the expand button, you can see the expanded Patient details as follows. On the left, you can also view a call icon beside the Mobile, that is used to call the patient on his cell.

4. Click the Clinical Time tab. The Clinical Time tab looks as follows.

5. 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.

   

6. Upon clicking on that, you will be presented with a range data picker where you can select the date range.

   

7. Upon clicking on the filed, you will receive the records based on the specified time period you select.

   

• The Pie chart refers to the total time spent by the program co-ordinator / provider on that particular patient dashboard.

  

6. On the Left Hand side, you can see a Drop Down field labeled as Activity, which contains the following options:
7. If you select the option other than All and Patient Monitoring you will see more Dropdown next to the activity where can filter the bills based on the service selected.

6.1 All - You can able to see all the bill's

• Billable - All the Billable bill's.
• Non-billable - All the Non-billable bills.

6.2 Patient Monitoring - You can see all bills under Patient Monitoring activity.

1. Billable - To add a bill under Billable in patient monitoring, click on the + Log Time button on the Right Hand side. After clicking on it, you will see a pop-up model as follows.

• Service - You can see all the available services. You can select any service to proceed with billing.
• Activity - You will have two options (Patient Monitoring, Billing). You can select any one activity to which you are willing to add a bill.
• Date - Select to which date you would like to be billed.
• From - select the from time.
• To - select the to time.

• Notes - Add a note that is related to the billing.

  Now click on the add button. The bill will reflect in the respective Activity Billing.

2. Non-billable - This bill will be added when you spend time on tabs other than CCM, RPM, TCM, PCM, and AWV services. This record will reflect when you navigate from the Patient dashboard to the patient listing.

6.3 Billing - You can view all bill's billing activity. Upon selecting the billing options in activity, you will see a new Service Dropdown on the Right Hand side. This filter will assist you in filtering 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 above image, when you click on any active service (such as CCM, RPM, TCM, PCM, AWV) in the patient listing, it will show you the following pop-up.

If you click on Yes, the timer will start (billing time will begin) and you will navigate to that service in the patient dashboard. If you click No, you will navigate to that particular service in the dashboard without billing.

Billing Flow

• If you have clicked on the CCM service and then clicked on Yes to bill the time, it will navigate you to the service with the billing timer ON. This action will disable other services because when you are billing for a particular service, you can't 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. Click on the Operational Reports Tab as follows.

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 like (PCM, TCM, RPM, AWV), and if you want to bill for a service, click on the Start Billing icon located at the Top below the header as shown below.

• Upon clicking on the icon, you will get a pop-up with a Dropdown menu to select the service you want to be billed for, as follows:

• If you click on the start button, it will start billing for that particular service. Please follow the steps Billing flow.

3.1 From Service:

If you want to start the billing when you are in a particular service tab, then you can directly bill by clicking on the Start Billing icon at the top and follow the steps for Billing flow.

7. 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 see an "Add Bill" button on the Top Right of the table. Click on it to show a pop-up for adding a bill as follows.
• You can also delete the clinical time by selecting the record and clicking on the delete button at the top right of the table.
• There is an option to download the records by clicking on the download button, which is at the top of the table.
• If you want to download the billable records, select the billable toggle and click on download.

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

  Note: If you select multiple records with different services, then it will be categorised as "others."

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

• Description - Based on the CPT code, you will receive some descriptors from which you can select.

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

• Provider - The provider's name will be pre-populated based on the record you selected in billings.
• Patient - The patient's name will be pre-populated based on the record you selected in billings.
• From Date - It will be pre-populated, and the date and time will be based on the oldest record selected.
• To Date - It 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 - It will be pre-populated when you select the CPT code. It is also editable.

  After clicking on Add, the billed records will be disabled. The bill will reflect in the billing tab.

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

• Upon navigating to the Bills tab, select the service type in which you have 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. Later, you can change it as needed.
  1. Clicking on RPM, CCM, TCM and Others tab, will display calls list with checkboxes for each row with details as follows:
• CPT code
• Time
• From (Date & Time)
• To (Date & Time)
• Topic
• Summary
• Status
• Action
1. CPT codes are different for all types i.e., RPM, CCM, TCM and Others. CPT codes for all reimbursement types are different.
2. Billing Period- From and To date range can be selected in the Billing period to display the calls between the selected range.
3. Click on CCM tab.

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  1. User can use the Add Row option to add a row in the given list with entering the details like Billing Type, CPT code, topic, Provider, Patient, Date, Start Time, End time, Meeting Notes and call type.

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  1. To edit the call details click on the Edit icon in Action, allows user to edit the details like Billing type, CPT code, topic, Date, Provider, Meeting Notes, call type for selected row in the list.

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  1. User can select the record from the list and click on Submit.
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  1. The submitted bills cannot be edited.
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  1. Each reimbursement type tab have filters as shown:
• All - Shows all the CCM call logs
• New - Displays all the newly submitted calls/ bills and are represented by Blue Color
• Submitted - Displays all the submitted calls/ bills and are represented by Light Green Color
• Rejected - Displays all the rejected calls and are represented by Red color
• On-Hold - Displays the calls which are kept on-hold and are represented by Amber Color
• Approved - Displays all the approved calls and are represented by Green color
1. You can view 2 actions in the Action - Edit and Delete. All New/ Rejected bills will have these icons enabled.
2. Once the Bill is submitted/ kept on-hold and Approved, these icons will be disabled.
3. On clicking the Rejected calls/bills, User can view the Rejected reasons, which shows the date with rejected reason.

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  1. Upon clicking the download icon, you will be able to access the Summary of the CCM Episode. Additionally, you can download it by clicking on the floating download button or use the print button to print the PDF.

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  • 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

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  Approve Time:

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  1. The calls logs that are being submitted are saved in the Billing Portal. When the Admin logs in he can view the following screen.
  2. By default, we have All Programs and All Providers selected. You can change it based on your preferences.

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

  2. 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.

     

     

  3. There are 5 filters - Status, Program, and Provider, Duration and Search Bills, using which we can search the bills to review.
  4. User can filter the submitted billing list based on the Status of the bill in 4 categories.
• Submitted Bills
• Bills on Hold
• Accepted bills
• Rejected bills
1. Patients which are qualified by rules engine for the set of rules mentioned for respective CPT code, will be ready to Bill and patients which do not qualify the set of rules mentioned are rejected by rules engine.
2. User can filter the submitted billing list based on the type of billing or product (All/RPM/CCM/RTM/TCM/PMPM)
3. Click on the Status filter and select Submitted Bill option and Program filter and select CCM . The following screen can be seen.

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  1. 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 or Quarterly, by default, we have Monthly selected.

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  1. User can filter the submitted billing list based on the provider name for the specific center.
  2. Search field will be available to search the required data on the dashboard.
  3. Below the filters, we can see the table with following headers:
• Checkbox - To select all the records
• Patient EMR ID
• Patient Name
• Date of Service ( Date on which the service was provided)
• CPT Type (RPM/CCM/TCM/Others CPT code and Topic)
• Note (Meeting Notes while scheduling)
• Provider Name
• Bill details (Bill ID and Month Date, Year on which billing was submitted )
• Actions (Approve /On Hold /Reject)
1. All the submitted bills in the list, in the checkbox form, user can select the bulk actions to mark the selected bills as Approved or Rejected. And also can download the bills by clicking on the Download option.
2. Click on the checkbox and click on the Accept selected bills at the right, to submit the bills. You will view a pop-up to confirm if you want to accept the bill or not. Click on Yes to accept the bill.

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3. We can also reject bulk bills by selecting the records and clicking on the "Reject selected claims" button, which will be visible in the headers once you select the bills. Upon clicking the button, a pop-up will appear where you have to enter the reason for rejecting the bills and click submit. The bills will then be seen under rejected bills.

   

4. You can perform actions - Approve, On Hold and Reject for individual calls. After the call log is being Approved/ is On Hold / Rejected. Those call logs will be categorised into Accepted/Rejected/On Hold respectively.

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

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  1. After the bills are accepted, we can view them by selecting the Status as Accepted.
  2. Here, to download the Bill report, check the box for an individual record or check the box in the header to download report for all the reports.
  3. We can download the report w.r.t any Status - All, Ready to bill, Submitted, On-Hold, Rejected and Approved.

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

  2. 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.

     

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

     

     
     

  4. 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.

     

     

Note: