Facility Invoices

Preview and generate one or more facility invoices using the Facilities page.

To get to the Facilities page, click Facilities on the navigation bar.

Note: Facility claims have to be submitted before they will appear in the With outstanding balance tab. If you don't see the claim charge you are looking for in this tab, go back to the Claim page and see if the claim has a submitted status.

Previewing a facility invoice

Previewing a facility invoice is a good way to ensure its accuracy and obtain an understanding of the final invoice's appearance. When you click the "Preview invoice" button, a PDF will display with a clear "Preview" label to differentiate it from the official invoice. Once you have reviewed the preview invoice, make corrections if necessary. When you are satisfied with the accuracy, click the "Generate invoice" button to create the final version.

To preview an facility invoice:

  1. On the navigation bar, click Facilities.

  2. Click the "With outstanding balance" tab.

  3. Click the name of the facility.

  4. Click the Queued claims tab. A list of claims that have yet to be invoiced displays.

  5. Click the Preview invoice button.

  6. Check the invoice due date. If you Select the invoice due date.

  7. Click the radio button next to the desired format. Read more about each format here.

  8. Click the Preview button.

    A PDF will open in a new tab in the format you selected. You can print or download the preview invoice.

Generating a facility invoice

Use the following instructions if you have previewed the facility invoice and are ready to generate it.

  1. On the navigation bar, click Facilities.

  2. Click the With outstanding balance tab.

  3. Click the name of the facility.

  4. Click the Queued claims tab. A list of claims that have yet to be invoiced displays.

    Check the invoice period: The invoice will include all the claims with service dates that fall within this date range and any claims prior to the range that have not yet been invoiced. For example, an invoice was generated for January. In February, a claim was created with a service date of 1/31. This claim will be included in the February invoice because it was not yet included in an invoice. To change the upcoming invoice end date, click the edit pencil, enter a new date, and then click Save.

  5. Click the Generate invoice button.

  6. Because a generated facility cannot be undone, you will see a confirmation window asking you if you are sure you are ready. If you are, click Yes continue.

  7. Change or verify the Invoice due date: The date you expect payment from the facility (will display on the invoice).

  8. There are several ways to format the invoice. If you have not done so already, go back and use the preview function to determine which format you want to use. If you know which format, click the format's radio button.

  9. Click Generate. You can download or print the invoice.

    Tri-fold the printed invoice and place it into a #10 business envelope. Ensure that the facility address displays in the envelope window.

Ways to format facility invoices

There are several invoice format types from which you can choose:

Note: The option you select will be enabled by default every time you generate an invoice for this facility.

  • Only display amount(s) due on invoices/1500s: Select to display only the amounts due on the invoices/1500 and not display contractual amounts.

    When you choose this setting:

    • Box 24F will reflect the amount due after contractuals are subtracted for each charge

    • The "Price per unit", "Charges", "Contractuals", and "Paid" columns will be hidden on the invoice

    • Box 28 will reflect the amount due after contractuals are subtracted for all charges

  • Single invoice with all claims (together): Generates a facility invoice with all the claims together.

  • Single invoice with all claims (together, including past invoiced claims): Generates a single facility invoice that shows the newly submitted claims followed by previously submitted claims. This format allows the facility to reconcile the amount shown in the "Previous amount due" field with past invoiced claims. (click image to enlarge)

  • Single invoice with all claims (separated): Displays a single summary page followed by one claim per page for each claim being invoiced.

  • Separate invoice, one per claim

  • 1500 per claim

Outstanding balances

Instead of continuing to generate a single invoice for every outstanding facility charge, you can combine all outstanding amounts into one invoice.

To being, click the With outstanding balances tab. This list shows the facility information, any new charges, and the outstanding balance. The outstanding balance is the total amount of charges invoiced to this facility minus discounts (contractual allowances).

Note: The "New charges" column shows new charges that have not yet been invoiced. If you want to send an invoice for only the new charges, click the With new charges tab.

Facilities with outstanding balances tab shows a list of facilities that have been invoiced but not yet paid.

  1. Click the facility name and then the Open submitted claims tab. you will see a list of claims for which there are outstanding balances.

  2. Click the Outstanding balance invoice button. Does this facility have new charges that have not yet been billed? If so, a window pops up. You have a choice, you can either click the link to go generate a invoice to the new charges or you can continue creating the invoice with outstanding charges.

    If there are new charges, a pop-up window opens.

    But wait! Maybe you want everything - outstanding and new charges in one invoice. To do that:

    1. Click the link in the pop-up window to generate an invoice with the new charges. You can either print out the invoice or save it to your PC, just don't send it. After you generate it, you will see the invoice in the "Past invoice" tab.

    2. Click the Outstanding balance tab. Now the list will include the invoice you just generated.

    3. Click the Outstanding balance invoice button.

Removing a claim from a facility invoice

You can remove a claim from a facility invoice after the invoice was generated.

Note: Currently, there is no notification or indication on the facility invoice that a claim was dropped and why the balance has changed. Because the claim was never invoiced it will not display under the "Previously Invoiced Claim Summary."

From the Claim page

When the claim is in a "Submitted – Facility invoice" status, a ‘Remove from facility invoice’ button will display.

After clicking Remove from facility invoice, the system will ask if you are sure you want to delete the claim from the facility invoice. If you click Yes then the claim’s status will change to "Suspended – Verify COB."

At this time, contractual allowances applied to the claim due to invoicing to the facility are reversed, (i.e. the claim’s balance is increased by the CA amounts) and the claim no longer displays on the Facility page.

From the Facilities page > Open submitted claims tab

A remove button appears under the "Open submitted claims" tab in the Remove column.

When you click the remove button:

  • The claim is removed from the facility invoice

  • Any contractuals on the claim for this facility will be auto-reversed

  • The claim’s status changes to "Suspended – Verify COB"

When a claim is automatically removed from the facility invoice

If the current payer is the facility on a claim and you:

  • Change the claim’s charges

  • Move away from the facility on the COB so that the current payer is no longer a facility

  • Mileage or LOS and update those charges

Then:

  • The system removes the claim from the facility

  • If there was a charge/mileage/LOS change then the claim’s status changes to "Follow-up – Charges corrected after submission"

  • If you are changing the COB so that the facility is no longer active, the claim’s status changes to "Suspended – Verify COB"

When the CO-45/contractuals are automatically reversed

  • Not reversed - When you use the move to next or move to previous payer buttons

  • Reversed - When you:

    • Remove a claim from a facility invoice

    • Change the charges when a facility is the payer

    • Change the COB such that the facility payer is no longer active

What to do if you incorrectly charged a facility

If you billed a facility and then noticed that the charge on the claim was incorrect, you can fix the incorrect charge and then send the facility a new statement.

  1. Go to the Claim page for the submitted claim. The status for this claim will be "Submitted - Facility invoice."

  2. Click the Charges tab and then click the edit icon.

  3. Update the charge(s) on the Claim page.

  4. Click Save changes.

  5. Click Resubmit to payer.

  6. Click the Facilities on the top navigation bar.

  7. Click the Queued claims tab. Your newly edited claim will display in this tab.

  8. Click the edit icon next to the 'Invoice period' field and select the correct date.

  9. Click Generate invoice. A new invoice will display with the updated charge information.