Mastering Billing' Standalone & Batch Claims

Name: Create Standalone & Batch claims on the Agency’s Billing section
Description: How to create a standalone / batch claim on the Agency’s Billing section.
Difficulty: Middle
Duration: Less than 7 minutes

Standalone claims

Summary:
Step 1- From the Agency Dashboard, access Billing.
Step 2- Click on Standalone Claims.
Step 3- Click on +New Claim.
Step 4- Select client.
Step 5- In the General tab, select Prior Authorization.
Step 6- Go to the Items tab, click on + Add and select From event.
Step 7- Select the range of dates that you want to include in the claim, the providers, and the event types. Once selected, click on Search.
Step 8- Select the events to be included.
Step 9- Click on Create.

Batch claims

Summary:
Step 1- From the Agency Dashboard, access Billing.
Step 2- Click on Batch Claims.
Step 3- Click on +New Batch.
Step 4- Select Payer.
Step 5- Select Health Plan.
Step 6- Click on Create.
Step 7- On the right side of the screen, next to the newly created batch, click to Edit.
Step 8- Within the batch, click on + Add claim.
Step 9- Select Other Claims / Events / Manual.
Step 10- Select the date range you want to include in the claim, the clients, the providers, and the event types. Once selected, click on Search.
Step 11- Select the events to be included.
Step 12- Click on Add.

Create Standalone & Batch claims on the Agency’s Billing section

Standalone claims

Step 1- From the Agency Dashboard, access Billing.


Step 2- Click on Standalone Claims.


Step 3- Click on +New Claim.


Step 4- Select client.


Step 5- In the General tab, select Prior Authorization.


Step 6- Go to the Items tab, click on + Add and select From event.

Step 7- Select the range of dates that you want to include in the claim, the providers, and the event types. Once selected, click on Search.


Step 8- Select the events to be included.

Step 9- Click on Add.


Step 10- Click on Create.

 

Batch claims

Step 1- From the Agency Dashboard, access Billing.

Step 2- Click on Batch Claims.


Step 3- Click on +New Batch.


Step 4- Select Payer.


Step 5- Select Health Plan.


Step 6- Click on Create.


Step 7- On the right side of the screen, next to the newly created batch and just below Actions, click to Edit.


Step 8- Within the batch, click on + Add claim.


Step 9- Select Other Claims / Events / Manual.


Step 10- Select the date range you want to include in the claim, the clients, the providers, and the event types. Once selected, click on Search.


Step 11- Select the events to be included.


Step 12- Click on Add.

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Florida Medicaid Trading Partner ID & EDI Agreement

Name: Florida Medicaid Trading Partner ID and EDI Agreement
Description: Configuring Florida Medicaid portal for EDI files submission.
Difficulty: Medium
Duration: 15 minutes

Summary:
Step 1: Visit http://home.flmmis.com.

Step 2: Log into the secure Web Portal using your account credentials.

Step 3: Select Providers.

Step 4: Choose demographic maintenance.

Step 5: Select EDI Agreement.

Step 6: Select the transaction types.

 Step 7: Add billing contact information.

Step 8: Read and Accept the agreement.

Step 9: Click “SAVE” at the end of the screen.

Step 10: Save the Trading Partner ID (TPID).

Florida Medicaid Trading Partner ID and EDI Agreement

Step 1: Visit http://home.flmmis.com

Step 2: Log into the secure Web Portal using your account credentials

Step 3: From the secure Web Portal landing page, select Providers

Step 4: Below the Providers option, choose demographic maintenance.

Step 5: From the Provider Informational panel, select EDI Agreement.

Providers without an existing Trading Partner ID (TPID) will see the message indicating that there is no TPID on file for the Provider ID. Users will indicate the transaction types they plan to send or receive under their TPID by selecting the checkbox next to the appropriate transaction.

If you already have a Trading Partner ID Steps 6 and 7 will not apply.

Step 6: Select the following transaction types:

  • 270/271 270/271 Health Care Eligibility Benefit Inquiry and Response
  • 276/277 Claim Status Request and Response
  • 837 Professional Health Care Claim

 Step 7: Add billing contact information (name, email, and phone)

Step 8: Read and Accept the agreement, basically accepting the process of submitting this type of file electronically.

Step 9: Click “SAVE” at the end of the screen.

Successful submission will produce the following message, which displays the user’s new TPID.

Step 10: Save the Trading Partner ID (TPID) as we will need this information.

 

by Editor

Exporting data from Behaviorsoft

Name: Exporting data from Behaviorsoft to Office Puzzle
Description: How to export data from Behaviorsoft and import it to Office Puzzle
Difficulty: Middle
Duration: Less than 10 minutes
Summary:

Exporting from Behaviorsoft
1. On the Client’s screen, click the Maladaptives tab or the Replacements/Skills tab.
2. Select the specific maladaptive behavior or replacement, and then click on the EXPORT DATA button under the GRAPHS column.
3. The EXPORT DATA pop-up screen will then appear.
4. Lastly, you can specifically choose to export data on specific dates. There is an option to enter a From Date and a To Date.
5. Once you have selected the Collection type and choose the specific dates, click Download Data. The data will then be exported in an Excel file.

Importing to Office Puzzle
6: Go to Client's Dashboard.
7: Click on the Service Plan button.
8: Click on ABA Therapy Service Plan.
9: Choose the required Category tab: Maladaptive Behaviors, Replacements, etc.
10. Click on the Edit button on the right side of the desired item.
11. Click on Imported Data tab.
12. On the main box, you can paste the dates and values from the Excel file that you’ve exported from Behaviorsoft.
13. Once you’ve finished, click on Update.

Exporting client data from Behaviorsoft to Office Puzzle

Exporting from Behaviorsoft

Step 1: On the Client’s screen, click the Maladaptives tab or the Replacements/Skills tab.

Step 2: Select the specific maladaptive behavior or replacement, and then click on the EXPORT DATA button under the GRAPHS column.


Step 3: The EXPORT DATA pop-up screen will then appear.


Step 4: Lastly, you can specifically choose to export data on specific dates. There is an option to enter a From Date and a To Date.

Step 5: Once you have selected the Collection type and choose the specific dates, click Download Data. The data will then be exported in an Excel file.

Importing to Office Puzzle

Step 6: Go to Client's Dashboard.

Step 7: Click on the Service Plan button.

Step 8: Click on ABA Therapy Service Plan.

Step 9: Choose the required Category tab: Maladaptive Behaviors, Replacements, etc.


Step 10: Click on the Edit button on the right side of the item.


Step 11: Click on Imported Data tab.


Step 12: On the main box, you can paste the dates and values from the Excel file that you’ve exported from Behaviorsoft.


Step 13: Click on Update.

by Editor

Backup Client

Name: Backup Client
Description: How to create a full backup of a Client.
Difficulty: Easy
Duration: Less than 2 minutes
Summary:
1. Go to Client's Dashboard.
2. Click on Manage.
3. Click on the Backups tab.
4. Click on the Request Backup button.
5. Once the Backup is completed you will receive an email and the backup file will appear here for you to download.

Important Notes:

  • This will backup all Documents associated with the client.
  • You are responsible for the storage required for the data.

Backup Client

Step 1: Go to Client's Dashboard.

Step 2: Click on Manage.

 

Step 3: Click on the Backups tab.

Step 4: Click on the Request Backup button.

Step 5: Once the Backup is completed you will receive an email and the backup file will appear here for you to download.

After is done:

by Editor

Create client event with EVV

Name: Create client event with EVV
Description: How to create an event/visit/session with EVV (Electronic Visit Verification)
Difficulty: Easy
Duration: Less than 2 minutes
Summary:
1. Go to Client's Dashboard.
2. Click on the Clock in button.
3. Fill in all the required fields.
4. Click on the Start Session button.
5. Now you can collect Data, capture Signatures, access linked Documents, etc.
6. Once the visit is over, click on the End button.
7. Fill in all the required fields. (including Signature if required)
8. Click on the End Session button.

Important Notes:

  • You are recommended to use our Mobile APP on your cellphone since GPS coordinates are more accurate.
  • If you don't see the Clock In button, your agency might have disabled this feature for you.
  • If GPS coordinates are required by the agency the device used (Phone, Tablet, Laptop) will need to have GPS capabilities and permission granted to Office Puzzle.
  • You can also create an event directly from the Calendar, but this will not include EVV information. Please click here for more details.

Create client event with EVV

Step 1: Go to Client's Dashboard.

Step 2: Click on the Clock in button.

 

Step 3: Fill in all the required fields.

Step 4: Click on the Start Session button.

Step 5: Now you can collect Data, capture Signatures, access linked Documents, etc. 

You continue working for the duration of the session.

Step 6: Once the visit is over, click on the End button.

Step 7: Fill in all the required fields. (including Signature if required)

Step 8: Click on the End Session button.

by Editor

Link or Unlink events with documents

Name: Link or Unlink events with documents
Description: How to Link or Unlink events with documents.
Difficulty: Easy
Duration: Less than 2 minutes
Summary:
1. Go to Client's Dashboard.
2. Click on the Documents button.
3. Look for the document you would like to Link/Unlink events and open it
4. Click on the Linked Events tab.
5. Check/Uncheck, the event(s) that you want to Link/Unlink with the document.
6. Click on the Update Linked Events button.

*** If you are missing or have extra information in your documents that is generated directly from the events in the calendar most probably the document is not linked to the events. These steps will help you Link/Unlink these events.

Link or Unlink events with documents

Step 1: Go to Client's Dashboard.

Step 2: Click on the Documents button.


Step 3: Look for the document you would like to Link/Unlink events and open it

**** As an example, please note that your documents might be called different.

Step 4: Click on the Linked events tab.

Step 5: Check/Uncheck, the event(s) that you want to Link/Unlink with the document.

Step 6: Click on the Update Linked Events button.

by Editor

Create client event from calendar

Name: Create client event from calendar
Description: How to create an event/visit/session from the Client's Calendar.
Difficulty: Easy
Duration: Less than 2 minutes
Summary:
1. Go to Client's Dashboard.
2. Click on the Calendar button.
3. Select the day when you want to create the event.
4. Fill in all the required fields. (including Signature if required)
5. Click on the Save/Save & Close button.

*** Please note, this will create all required documents linked to this event as well.

Create client event from calendar

Step 1: Go to Client's Dashboard.

Step 2: Click on the Calendar button.

Step 3: Select the day when you want to create the event.

Step 4: Fill in all the required fields. (including Signature if required)

Step 5: Click on the Save/Save & Close button.

https://www.youtube.com/watch?v=_KHb6d-mcvw

by Editor

Save user signature

Name: Save user signature
Description: How to save the signature of a User
Difficulty: Easy
Duration: Less than 1 minute
Summary:
1. Access your profile.
2. Click on the Manage button.
3. Click on the Signature tab.
4. Click on the New signature.
5. Draw the new signature inside the box.
6. Click on the green button Sign.

How to save my signature

Step 1: Access your profile.

 

or

Step 2: Click on the Manage button.

Step 3: Click on the Signature tab.

Step 4: Click on the New signature.

Step 5: Draw the new signature inside the box.

Step 6: Click on the green button Sign.

 

by Editor