Billing Statuses and their definitions
Draft: This means that you are still working on the bill and it will not be sent to the Payment Issuer.
Ready/Ready To Submit: This means that the bill is complete and our system can send to Teleplan for example (this is done every evening).
Submitted: The bill has been submitted to the Payment Issuer for approval.
Attention Required: This bill has been rejected by the Payment Issuer and needs review and resubmission.
Completed: This bill has been approved by the Payment Issuer and will be paid out on the next pay date.
Cancelled: This bill has been cancelled.
Your default status may be set to either Draft or Ready, depending on your billing integration settings.
If it is set to Ready and you have completed one of the above steps, nothing further is required until remittance day. The bills will be sent automatically to your Payment Issuer (e.g. Teleplan/ MDBilling).
If your default status is set to Draft then you will need to navigate to the Billing Dashboard, review the bills for accuracy and change the status to Ready, in order for the bills to be sent to the Payment Issuer.
Managing Bills before submission
For you to have a good overview of which bills need to be reviewed, we recommend using the sorting filter within the Billing Dashboard and setting the status filter to Draft.
All of the bills with the status of Draft will be display for you to review prior to Submission. To submit, manually change the status to Ready to Submit.
Managing Remittance Bills
After remittance day, it is time to go through and check for any billing items that require attention.
Use the Status Filter Options in the Billing Dashboard and configure the date range as well as the status, in order to see all of the bills that have not gone through for payment (rejected).
Once these filters have been applied, your billing dashboard will display all of the remittance reports that need to be actioned.
This example shows one rejected bill that will require review:
Note: The amount in the payment amount window displays that this item is still unpaid
By clicking on the item the billing dialogue box will be revealed. This is where you will see why the bill was rejected.
In the above example, you are able to see that this patient’s Personal Health Number (PHN) has either been entered incorrectly, or is currently invalid.
Automatic PHN Validations
When you enter a PHN in a patient chart, you will automatically see if the patient is eligible.
In the below screenshot, you can see that the patient with the rejected bill does not have a valid number:
Note: If the patient’s name or Date of Birth is not exactly the same as how the patient is registered with a specific health plan, the PHN will be marked as invalid. Ensure that all names, including middle name, and patient’s DOB have been entered correctly.
When a patient has a valid PHN, a green checkmark displays:
Once the billing error has been identified and fixed, go back to the bill in the Billing Dashboard and change the status back to Ready to Submit.
Once you have changed the status to Ready to Submit, click Save. This bill will be added back to your batch of bills to be sent to the Payment Issuer that evening for the next remittance period.