Overview of the PatientKeeper Billing Process
Access Restrictions on the Charges Tab
A charge transaction can have four possible statuses in the PatientKeeper system, each of which is described below. Although this documentation and PatientKeeper staff often use phrases such as “in the Holding Bin” or “send the charge to the Outbox” to visualize the concept of a charge moving from one billing phase to another, please note that Draft/Draft(HH), Holding Bin, Outbox, and Sent to Billing are in fact simply statuses assigned to a charge transaction, as it moves from it’s earliest to last possible status, in sequential order.
1.Draft or Draft(HH): These statuses indicate that the provider chose to save the charge as draft. Draft indicates that it was created on the PatientKeeper web platform, whereas Draft(HH) indicates that it was created on a handheld device. Draft charge transactions can be edited.
Draft transactions remain in Draft or Draft(HH) status until either of the events below occurs:
–A user edits the transaction and submits it as a completed transaction by clicking the Submit button (with the Draft box unchecked). At that time, the charge is sent to either the Holding Bin or the Outbox (see Step2).
–The draft expires, at which time the charge is assigned an error status of Expired Draft and the charge is sent to the Holding Bin. There are settings are both the Institution and User level that determine how long charges remain in a draft state before they expire.
(A provider is not required to save a charge as a draft; this status can be skipped entirely.)
2.Holding Bin: The charge transaction is considered “complete” (not a draft), but it may or may not have an error status assigned to it. The Holding Bin state is meant to be a review period, during which providers or billing administrators can review charges and make any necessary corrections.
Which charges are sent to the Holding Bin?
–In a typical configuration, when a provider initially submits a charge transaction as a completed transaction by clicking Submit, the charge is sent to Holding Bin if it has errors, or to the Outbox if it does not have errors (although administrators can route all charges to the Holding Bin status if they feel it is necessary, based on the value of several settings at the Department and User level).
–If a user has questions or issues with a transaction, they can hold it for review, which forces it into a Holding Bin status.
–Draft charges that have expired are always sent to the Holding Bin (with an error status of Expired Draft).
–Completed charge transactions that have auto-added codes are always sent to the Holding Bin.
Once a billing administrator has reviewed the charges in the Holding Bin status, made any necessary corrections, and deems them to be complete and accurate, they send the charge transactions to an Outbox status.
3.Outbox: The charge is now almost ready for final billing; either the PatientKeeper code edit engine has found no errors with it and it was sent directly to an Outbox status after the user clicked Submit, or it has been reviewed and corrected by a billing administrator and they have sent it to an Outbox status.
In some cases, a charge might to be sent from an Outbox status back to a Holding Bin status:
–Certain users may be granted the ability to make last minute edits to charges while they are in an Outbox status. However, if that feature is not enabled, then a level 1 or 2 administrator can send the charge back to the Holding Bin status if corrections are necessary.
–If certain events occur which cause a charge transaction to be revalidated (such as an update to patient or insurance information, a change to the date range for a visit, or the addition of new charges), and errors are found on the transaction during that revalidation, the charge may be automatically sent back to a Holding Bin status. This feature can be enabled or disabled via an Institution level setting.
Once a billing administrator has reviewed the charges in the Outbox status and deems them to be complete and accurate, they can manually commit the charge transactions to a Sent to Billing status. Or, your system may be configured to automatically commit charge transactions to billing based on a schedule.
Please note that if your organization has implemented a Billing Hold Period, then the charges may be held in the Outbox for a short period of time before they are committed to a Sent to Billing status, thereby giving users a window of opportunity for making corrections or changes.
4.Sent to Billing: The charge has been added to a batch of charges, which are either automatically interfaced to your billing system (most common scenario), or gathered into a Batch Report which administrators can use to manually transcribe them into your billing system.
From this point forward, the charges may be viewed on handheld devices or on the web application, but they cannot be edited by any user (unless a Level 1 administrator sends them back to the Holding Bin status).
