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This guide is intended to navigate you through the process of billing within VEHRDICT, encompassing the creation of invoices, application of insurance, and claims submission. By following the steps outlined here, you'll establish a solid foundation that ensures efficiency and accuracy when it's time to manage invoices and process claims. Preliminary steps are crucial for a seamless billing cycle.
= VEHRDICT Billing Workflow Guide =


==Encounters==
This guide is intended to navigate you through the process of billing within '''VEHRDICT''', encompassing the creation of invoices, application of insurance, and claims submission. By following the steps outlined here, you'll establish a solid foundation that ensures efficiency and accuracy when it's time to manage invoices and process claims. Preliminary steps are crucial for a seamless billing cycle.


To be able to create an invoice, you must have something you are charging for in the first place, which will be a doctor's visit, or an '''Encounter'''. Refer to the '''Encounter''' section under the Patient Overview tab for a refresher on how to create an encounter.
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==Insurance==
== Encounters ==


Patients are not required to have insurance for us to treat them, but if they do, we want to be sure that we apply it appropriately to the invoice so that the other parties can handle the claim appropriately. (double check this) If a patient does have insurance, you and the patient must be sure that all of the sections are filled out when adding the insurance provider. Refer to the '''Insurance''' section under the '''Patient Overview''' help tab for specifics, and make sure that it is filled out appropriately so that it can be easily applied to an invoice.
To be able to create an invoice, you must have something you are charging for in the first place—a doctor's visit or an '''Encounter'''. Refer to the '''Encounter''' section under the Patient Overview tab for a refresher on how to create an encounter.


==Invoice List==
{{Tip|Always tie your invoice to a specific encounter. This keeps your billing data structured and traceable.}}


To access a patient's invoice(s) you must first select a patient from '''Patient Search'''. After you have done so and have navigated to their dashboard, you will see an invoice option at the top of the page to the right of their picture & name. Select this option. You will then see a list of invoices, the amount depending on how many are active/in progress.
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==Adding an Invoice==
== Insurance ==


To begin adding an invoice, instead of selecting '''Add New''' on the invoice page, you are instead going to navigate to the encounters page. You must select an encounter before you add an invoice, because it has to be tied to the very thing that you are paying for. Once you have selected an encounter, click the blue '''Invoice''' button to begin. You should see a page that looks like this:
Patients are not required to have insurance, but if they do, it must be applied correctly to allow for third-party reimbursement. Make sure all required sections are accurately filled out when adding an insurance provider.


Refer to the '''Insurance''' section under the '''Patient Overview''' help tab for detailed steps.
{{Warning|Incomplete insurance data can delay claims or lead to denials. Always verify all tabs—General, Subscriber, Employer—are filled in.}}
---
== Invoice List ==
# Navigate to '''Patient Search''' and select the desired patient.
# From the patient dashboard, click the '''Invoice''' tab located to the right of the patient's picture and name.
# This will bring up a list of existing invoices associated with the patient.
---
== Adding an Invoice ==
Unlike other entries, invoices are created from an encounter:
# Go to the '''Encounters''' tab and select an existing encounter or create a new one.
# Click the blue '''Invoice''' button next to the desired encounter.
You should now see the invoice creation screen:


[[File:invoice_nx.jpg|800px]]
[[File:invoice_nx.jpg|800px]]


---


Once you are here, your next step is to fill out the billing questions. Below the insurance drop down box and next to the words '''Billing Questions''' you are going to select the button that says '''Add'''. A page will then appear with questions and specific required sections to fill out (see below).
== Completing Billing Questions ==


# Under the '''Insurance''' dropdown, click the '''Add''' button next to '''Billing Questions'''.
# Complete the popup form by answering all relevant questions.


[[File:billing_q_nx.jpg|800px]]
[[File:billing_q_nx.jpg|800px]]


---


Upon accurately completing the billing information, proceed to the '''Add Invoice Item''' section. Here, detail the services provided to the patient, ensuring the information reflects the treatment received. Once all entries are made, click '''Save Changes''' to record the invoice item. This step is vital for maintaining accurate and comprehensive billing records.
== Adding Invoice Items ==


Refer to "Codes" section to understand more about how to select a code
After completing the billing questions:


# Scroll down to the '''Add Invoice Item''' section.
# Input the details of the services rendered (code, description, quantity, price).
# Click '''Save Changes''' to add the item.


[[File:invoice_item_nx.jpg|800px]]
[[File:invoice_item_nx.jpg|800px]]


You can view and manage all added invoice items by clicking '''View Forms'''.


After successfully adding an invoice item, you are building a critical part of the patient's billing documentation. These documents are readily accessible for review and can be viewed at any stage by navigating to '''View Forms''', where you can select and review the desired documents. This function ensures that all billing items are transparent and traceable.
---


==Submitting a Claim==
== Submitting a Claim ==
To submit a claim for an invoice within VEHRDICT, navigate to the invoices section and select the relevant invoice. On the invoice page, click on the '''Submit a Claim''' button. A dialog box will appear with several options to choose from. Ensure you select "Submit Claim" to proceed with the claim submission, or choose an alternative action if you are not ready to submit. This process is critical for efficient billing management and claim processing.


# Go to the patient's '''Invoice''' tab and select an invoice.
# Click the '''Submit Claim''' button.
# In the pop-up dialog, confirm by selecting "Submit Claim".


[[File:claim_nx.jpg|800px]]
[[File:claim_nx.jpg|800px]]


Once submitted, you will be redirected to a confirmation screen:


Once you have officially submitted a claim, it should take you to another page that looks something like this:
[[File:Submitc.jpg|800px]]


Back in VEHRDICT, refresh the page to view the updated claim status:


[[File:Submitc.jpg|800px]]
[[File:Claimupdate_nx.jpg|800px]]


---


When you return to VEHRDICT, refresh your page, and you should see a status update on the right hand side under "Claim" that should look like this:
== Applying a Payment ==


To apply a payment:


[[File:Claimupdate.jpg|800px]]
# Click on '''Apply Payment'''.
# Enter payment amount and select '''Insurance''' or '''Self-Pay''' accordingly.
# Save to update the balance due.


---


The claim has successfully been submitted and you can track the progress from this page or from the Invoice List page.
== Codes Explained ==


==Applying a Payment==
Understanding medical billing codes is key to selecting the correct procedure:
To apply a payment, simply select the "Apply Payment" button and fill in the necessary information, being sure to select insurance if the patient has it.


=== HCPCS ===
"Healthcare Common Procedure Coding System" – Covers medical procedures, supplies, equipment, and services.


[[File:Apply.jpg|800px]]
* Level I: CPT4 (see below)
* Level II: Non-physician services like ambulance, DME, and supplies.


=== CPT4 ===
"Current Procedural Terminology" – Standardized codes for medical services and procedures, used for billing and documentation.


==Codes==
=== ICD10 DX ===
There are several options to choose from when adding an invoice option. This section will review what the letters stand for, and what the code itself means.
"International Classification of Diseases, 10th Revision – Diagnosis" – Codes for documenting patient conditions and diagnoses.


===HCPCS===
=== ICD10 PCS ===
Stands for "Healthcare Common Procedure Coding System" and is a set of healthcare procedure codes that are based on the American Medical Association's Current Procedural Terminology. These codes are a collection of standardized codes that represent medical procedures, supplies, products and services, and are used to facilitate the processing of health insurance claims by Medicare and other insurers. HCPCS is divided into two levels. Level I is CPT4, a numeric coding system and Level II is a standardized coding system that is used primarily to identify drugs, biologicals and non-drug and non-biological items, supplies, and services not included in the CPT code set jurisdiction, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies.
"Procedure Coding System" – ICD10 procedural codes for inpatient hospital settings.


===CPT4===
{{Tip|Need help picking a code? Refer to the integrated "Codes" lookup tool within the invoice form.}}
CPT Stands for "Current Procedural Terminology" and is level I of HCPCS. It is a uniform coding system consisting of descriptive terms and identifying codes that are used primarily to identify medical services and procedures furnished by physicians and other health care professionals.


===ICD10 DX===
---
ICD10 Stands for "International classification of Diseases, 10th revision"


===ICD10 PCS===
By following these steps in VEHRDICT, you'll ensure that your billing process is compliant, transparent, and streamlined for fast and efficient reimbursement.
This code is similar to the previous one, but the "PCS" stands for "Procedure Coding System"

Latest revision as of 16:26, 20 June 2025

VEHRDICT Billing Workflow Guide

This guide is intended to navigate you through the process of billing within VEHRDICT, encompassing the creation of invoices, application of insurance, and claims submission. By following the steps outlined here, you'll establish a solid foundation that ensures efficiency and accuracy when it's time to manage invoices and process claims. Preliminary steps are crucial for a seamless billing cycle.

---

Encounters

To be able to create an invoice, you must have something you are charging for in the first place—a doctor's visit or an Encounter. Refer to the Encounter section under the Patient Overview tab for a refresher on how to create an encounter.

Tip: Always tie your invoice to a specific encounter. This keeps your billing data structured and traceable.


---

Insurance

Patients are not required to have insurance, but if they do, it must be applied correctly to allow for third-party reimbursement. Make sure all required sections are accurately filled out when adding an insurance provider.

Refer to the Insurance section under the Patient Overview help tab for detailed steps.

Warning: Incomplete insurance data can delay claims or lead to denials. Always verify all tabs—General, Subscriber, Employer—are filled in.


---

Invoice List

  1. Navigate to Patient Search and select the desired patient.
  2. From the patient dashboard, click the Invoice tab located to the right of the patient's picture and name.
  3. This will bring up a list of existing invoices associated with the patient.

---

Adding an Invoice

Unlike other entries, invoices are created from an encounter:

  1. Go to the Encounters tab and select an existing encounter or create a new one.
  2. Click the blue Invoice button next to the desired encounter.

You should now see the invoice creation screen:

---

Completing Billing Questions

  1. Under the Insurance dropdown, click the Add button next to Billing Questions.
  2. Complete the popup form by answering all relevant questions.

---

Adding Invoice Items

After completing the billing questions:

  1. Scroll down to the Add Invoice Item section.
  2. Input the details of the services rendered (code, description, quantity, price).
  3. Click Save Changes to add the item.

You can view and manage all added invoice items by clicking View Forms.

---

Submitting a Claim

  1. Go to the patient's Invoice tab and select an invoice.
  2. Click the Submit Claim button.
  3. In the pop-up dialog, confirm by selecting "Submit Claim".

Once submitted, you will be redirected to a confirmation screen:

Back in VEHRDICT, refresh the page to view the updated claim status:

---

Applying a Payment

To apply a payment:

  1. Click on Apply Payment.
  2. Enter payment amount and select Insurance or Self-Pay accordingly.
  3. Save to update the balance due.

---

Codes Explained

Understanding medical billing codes is key to selecting the correct procedure:

HCPCS

"Healthcare Common Procedure Coding System" – Covers medical procedures, supplies, equipment, and services.

  • Level I: CPT4 (see below)
  • Level II: Non-physician services like ambulance, DME, and supplies.

CPT4

"Current Procedural Terminology" – Standardized codes for medical services and procedures, used for billing and documentation.

ICD10 DX

"International Classification of Diseases, 10th Revision – Diagnosis" – Codes for documenting patient conditions and diagnoses.

ICD10 PCS

"Procedure Coding System" – ICD10 procedural codes for inpatient hospital settings.

Tip: Need help picking a code? Refer to the integrated "Codes" lookup tool within the invoice form.


---

By following these steps in VEHRDICT, you'll ensure that your billing process is compliant, transparent, and streamlined for fast and efficient reimbursement.

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