If you are a provider, the standard and most efficient way to bill a third-party insurer for a visit is from an encounter. If you start the encounter from the appointment, the bill is automatically linked to the appointment - making it easier to confirm that all your appointments are billed.
💡Tip: If you use the same billing codes for specific appointment types or presenting issues, you can add billing items to encounter templates, making your billing workflow even more efficient. Refer to Creating encounter templates.
Steps
1. Start an encounter from an appointment. See Other appointment actions.
2. If applicable, select an encounter template (with or without billing items added). See Starting an encounter.
3. In the Billing Items section of the encounter, beside Template, select the insurance company you want to bill.
4. If needed, complete or change the other fields under Insured Payment Details. For more information and detailed descriptions of the fields, refer to Modifying a third party bill's billing practitioner, location and other bill details (with eClaims enabled)
5. To add a billing item (service code) to the bill, click +Insured Billing.
📌 Note: If you selected a template with added insured billing items, the items are displayed. Click a billing item to modify or delete it.
A New Billing Item window appears.
6. Complete the relevant fields using the below table:
Field | Description |
Code/Description | Type the code and description of the service offered.
To search by code, start typing the code in the first search box. To search by description, start typing the description in the second search box. Select a match from the list.
💡 Tip: Select the star icon next to the specific code to save the code to your favourites. Every time you create a bill, the starred favourites appear first in the list. |
Base Amount | Type the fee amount. 💡Tip: To save time, you can create billing templates with set amounts. |
Quantity | Type the number of units or click the up or down arrow to change the number of units. |
Diagnosis Codes | Enter the diagnosis code, or start typing a description to search for and select a diagnosis code from the list. 💡 Tip: Select the star icon next to the specific diagnostic code to save it to your favourites. Every time you create a bill, the starred favourites appear first in the list. 📌 Note: The list of diagnosis codes available depends on what is selected as your Default Diagnosis Template in Settings > Templates. SeeConfiguring diagnostic codes for your account. |
Service Date | If you are logged in as a billing provider and the patient had a recent (past) appointment booked in your schedule, the date defaults to the appointment date. If you are not a billing provider, the date defaults to the Visit Date specified at the top of the encounter. To change the date for the specific billing item, click the calendar icon, or type. |
Time | The time defaults to the appointment time. |
7. To save your changes, click outside the New Billing Item window when you are finished adding the service code.
8. To add additional service codes, click + Insured Billing.
9. To edit a billing item, click it and make the required changes.
10. To delete a billing item, click it and click the trash can icon in the top-right corner.
11. Save or Sign the encounter.
📌 Note: The claim does not appear in the patient chart’s Insured Billing section or the Billing dashboard until you sign the encounter.
Updated June 20, 2024