Maximum Flexibility for Resident Account Management
The NetSolutions AR-Billing system is a powerful and flexible solution for managing resident accounts and bill payors. It offers a cost-effective method of connecting facilities for centralized AR and Billing.
The robust features of our AR-Billing solution are expertly tailored to long-term and post-acute care facilities because they are driven by our customers. Our client-focused tools enhance Revenue Cycle Management through efficient processes resulting in full and timely reimbursement and optimal cash flow.
Accurate and Automatic Billing
The system’s power lies in its profile windows that accept an amazing amount of data and rules on payor plans and residents’ coverage. AR-Billing uses these profile rules to generate claims according to your facility’s needs and preferences, and those of your residents.
You and your NetSolutions Implementation Consultant work to set up your rules. Once these are established, AR-Billing works in the background to deliver fast, bullet-proof performance every day. AR-Billing handles Medicare, Medicaid, commercial insurance and managed care, and guarantor billing.
You can specify:
- Billing cycles for optimum cash flow by payor: weekly, monthly, and bi-monthly
- When to send No-Pay/Benefits Exhaust bills
- An unlimited number of plans for each payor, including the bill format needed for each plan
- Limits or minimums on specific ancillary items
- Billing criteria for hospital leaves
- Plan requirements, such as whether it pays for the day of discharge or admit
Learn more about our EHR products
Bill multiple residents in one click
Our One-Touch Billing feature adds even more automation to the claims process. With one click it handles all steps required to produce bills for groups of residents.
It works by using billing lists of residents you set up in master files. The lists are defined by criteria such as time period, payor, and bill spec. When it’s time to bill, you simply select a list, review its contents, identify any claims to be held or omitted, and hit the Process button.
From there, One-Touch Billing:
- Calculates charges
- Generates bills and bill data
- Creates paper and electronic output
- Emails you when processing is complete
- Generates the Billing Report
- Generates a Summary form Electronic Report
- Gives you the ability to edit UB data and reprocess the claims
Automated coordination of benefits
AR-Billing automates the coordination of benefits among multiple payors. When you add residents, you use templates to set up their reimbursement profiles with information on all their eligible plans, including the order of payment. Following those rules, the software pro-rates the charges for each payor and produces the claims. Charges not covered by one payor are passed on to the next.
Hands off retroactivity and rebills
What do you do when you find out a resident has been approved for Medicaid after billing as private pay? With AR-Billing, you simply change the primary payor to Medicaid in the reimbursement profile and retroactivity functions take care of the rest.
AR-Billing prepares a Medicaid claim and generates a GL journal entry that is posted to the current month with the appropriate service date. Retroactivity functions embedded throughout work in the background to make all the necessary changes. For example, AR-Billing’s retroactivity features update YTD revenue, contractuals, and resident days.
Streamlined Medicare billing
AR-Billing complies with HIPAA Transaction Standards for electronic Medicare and Medicaid claims in the ANSI 5010 format, remittance advice, and the National Provider Identifier (NPI) in each state.
AR-Billing tracks Medicare for 100 days automatically, including leaves and hospital stays. If the level of care changes to non-skilled, it pushes charges to the resident’s next payor.
When installed on a SQL database with NetSolutions clinical applications, data from MDS 3.0 for Medicare PPS billing is available on a page designed for billers. Updated for Change of Therapy assessments, this page includes data on billing periods, assessment type, assessment reference date, diagnosis and PDPM score. You can review MDS data or opt for it to flow automatically to claims.
Additional Medicare billing features
- Supports Medicare Part B Therapy Cap, including billing with modifiers, and tracking the cap by resident with reports based on therapy used and when the cap is exceeded.
- Generate Medicare No-Pay and Benefits Exhaust bills automatically per CMS rules.
- Numerous features for Medicare regulations, such as Interrupted Stay Policy
270/271 Eligibility Interface
The NetSolutions 270/271 Interface will send a real-time query about a beneficiary’s eligibility in the 270 format to CMS, Medicaid, and other commercial payors through an eligibility vendor. The eligibility information will be returned in a 271 message that is sent back to your system through the eligibility vendor.
The 271 response will be translated and the information displayed in a readable report format in NetSolutions AR-Billing. The 270/271 Eligibility Interface is a separate purchase.
Electronic remittance advice
AR-Billing accepts Electronic Remittance Advice in the HIPAA standard ANSI 835 format. Electronic remittance eliminates entering each line and manual reconciliation; simply import the file. AR-Billing matches remits with claims and reports discrepancies. The Electronic Data Interchange feature pulls data from the 835 message and displays it in a readable format.
Additional Billing Features
- Offers user-defined billing cycles by payor, such as weekly, biweekly, or early bills
- Supports calculating charges as well as producing bills and reports for the next billing period without closing the current period
- Tracks ancillary fees for inventory and reporting
- Automates contractual adjustments according to rules set up by your facility
- Collects data on residents’ hospital stays including leaves and discharge
- Accommodates date-sensitive setup of ancillary items, including cost, price, and markup, with a HCPC/CPT code lookup
- Supports charging for both an apartment and a bed during the same time span
- Bills for reserving beds as an option
- Creates electronic bills for multiple payor types with same bill spec
Increased Efficiency for Every Billing Process
NetSolutions’ Financial Suite improves efficiency by creating an interconnected system of data points and functionality that simplifies every billing process. With a streamlined end-of-month closing process and across-the-board changes for prices and payor rates, you’ll get more done in less time.
Connect with other financial applications
With tons of integrations and interfaces available, your AR-Billing system is able to send and receive information from just about anywhere.
- Export data to NetSolutions General Ledger and GL software from other vendors
- Integrate with NetSolutions Insight dashboard for custom reporting and key indicators
- Interface with acute care, pharmacy, and lab systems through HL7
- Interface with bar code systems to import ancillary charges
- Integrate with NetSolutions ADT and MDS 3.0 to directly share resident information and census status with data needed for Medicare PPS billing
Learn more about The NetSolutions Financial Suite
Additional efficiency features
- Option to verify all deposits are in balance before close
- Provides one page for viewing a resident’s complete account history
- Add future month information without closing current month
- Maintains separate lists of diagnoses’ sequence order for billing and clinical use
- Supports multiple fee schedules for payors which can be set up by copying and pasting schedules
- Imports paper forms such as insurance cards using NetSolutions eDocuments
- Offers an easy process for posting receipts to the appropriate accounting period, preserving the aging of receivables
- Supports multiple report writers with ODBC-compliant database
- Supports multiple bank accounts
- Offers features for apartments, such as maintaining guest lists, reservations, and generating one bill for a couple sharing an apartment
Collections Just Got Easier
Collections functions include expanded tools for reporting, a summary page, collection letters, and the ability to extract usable information from data messages.
Send collection letters faster
No more searching for information, or writing letters from scratch. Send collection letters faster with features for building letter templates with variable fields that are automatically filled by information in your residents’ records.
Simplify payor message information
Sending electronic claims in the ANSI 837 format is the first step of the electronic revenue cycle. In response, payors send you messages, but extracting meaningful information is traditionally very difficult.
AR-Billing’s Electronic Data Interchange feature pulls out important data and displays it in a clear and readable format. The message formats are the 270/271 eligibility (separate purchase), claims submission (837), claim receipt acknowledgment (277, part of 837), and payment (835).
The Collections Summary Page pulls information you need to take action and view the current status in a highly efficient format. Use filters to select the time period, residents, payors/plans, days outstanding, and amounts. Outstanding balances are displayed by resident, payor/plan, and time period. Choose a payor/period to see charges, receipts, adjustments, and balances for your selection.
Other features include an aging button to show real-time outstanding balances. Data such as payor phone numbers are on the page where you enter and view notes and schedule due dates.
Flexible Chart of Accounts
The NetSolutions Chart of Accounts structure provides maximum detail and flexibility. You can set up the Chart of Accounts to track at the levels of facility, business unit (such as Alzheimer’s wing), and a further subcategory of Product Line (such as a Certified Distinct Unit). Add more detail by using the item position to define categories such as apartment and durable medical equipment.
Import files from third-party systems
The Batch Charge Interface Module imports files of resident charges from third-party systems, such as those that use bar code technology, to capture data including
- Inventory items
- Therapy charges
- Orders for pharmacy, x-ray, and lab
AR-Billing prepares a validation report on the batch file that can be viewed before the charges are posted to residents.
User access your team needs
Security profiles of individuals and groups start with access to one or more facilities and provide password security at the levels of screens and menus. Access for each group also can be set by activity, such as adjustments, apply cash receipts, and calculate charges.
In addition to more than 100 standard on-demand reports, NetSolutions’ AR-Billing system offers easy to build customizable reports to ensure every long-term and post-acute care facility has access to the exact data they need in all of their financial reports.
Need to drilldown your data? You can specify sorting criteria and other variables such as time periods and residents when generating reports.
With NetSolutions you can create custom reports that combine clinical and AR-Billing data, allowing you to add your custom reports to the User Reports menu. Custom reporting is also available with Insight, our dashboard software.
Learn more about our Insight Dashboard
With an unlimited number of reports, you can see all outstanding accounts for all residents for a specified payor. Additionally, you can review all collection activity for one resident across all that resident’s payors.
Report filters let you pinpoint collection data by
- Number of days outstanding
- Days without payment
With so many on-demand report options, you’ll be sure you can show the data you need in the way that it needs to be seen. Here are a few of our customers’ top used on-demand reports:
- Resident Ledger: Available from the Financial Snapshop without first calculating charges
- A/R Reconciliation: Summarizes month’s activity with the beginning and ending balance. Sorted by plan within payor type.
- A/R Ledger: Lists billing and account detail activity for all residents for a billing period.
- Resident Roster: Resident information such as bed, admission date, payor or plan level of care, and private portion amount billed under Medicaid.
- Monthly Census: Lists the payor and level for each day of the month for residents with a stay during the date range specified. Offers sort options.
- Ancillary Orders: Detailed data on each resident’s ancillary orders, including frequency, start/end dates, price, override, and gross dollar amount.
- Adjustment Posting: Lists all adjustments posted for a specific date range.
- Retro Adjustments: Lists details of all retroactive changes performed during a specific date range.
- Ancillary Charge Summary: Lists ancillary charges processed by payor type.
- Collections by Payor: Shows ending balances by AR period and receipt amounts (less Resident Funds ) applied to ending balance after report end date.
- Routine Care Reconciliation: Shows room and board by payor, plan, and level with gross charges, reimbursement amounts, and contractual adjustments. Shows GL accounts affected by bed charge activity.
- Profile Reports: Displays data from resident and payor profiles such as Plan Items with Rates.
- Aging by Month: Lists resident account balances by payor, by aging category, with options to detail amounts over 180 days. Run it by resident status, display collection notes, and show charges, payments, and adjustments for total.
- Aged Outstanding Balances: Lists resident receivable balances by payor/plan. Options include outpatients and discharged residents.
- Medicare Financial Log: Lists Medicare Part A and/or B charges grouped by revenue code along with any payments made by the intermediary.
- Billing Recap: Room and ancillary charges, advance billing, receipts, total billable days by payor.
- Journal Entry Summary/Detail: Resident financial activity. Sales Journal and Cash Receipts Journal.
- Aged Ledger: Displays detailed data used to generate period balances on the Aged A/R report.
- Open Item Listing: Shows outstanding receivable amounts with collection notes and resident’s Medicare and Medicaid numbers.
- Collections Activity: Shows the last collection note activity for any outstanding balances and includes current month payments posted.
- Insurance Aged Trial Balance: Displays the aged accounts receivable balance for each account for each resident by payor type and plan for a particular A/R period, can extend to 360 days.
- Activity Log: Lists all activity by date range, type of activity, and/or user ID. Use for auditing, monitoring staff activity, and identifying retraining needs.
Services and System Information
Our AR-Billing is Web-based software, part of our complete .NET/SQL Server-based billing and clinical system. NetSolutions offers you a choice of self-hosting or our High-Performance Hosting Services offering LTC a state-of-the-art data center, private cloud, and IT maintenance.
Learn more about our Long-Term Care Technology Services