This is a document that shows how to edit a per diem payor source.
Per Diem - Change Payor
1. On the Clinical Manager workspace, click the keyboard.
2. Double click on the episode that needs adjusting this will bring up the window containing client information.
3. Click on the Payor Source tab.
4. At the bottom middle of the window, click on Add Payor Source.
5. Select Primary and pick new Payor Type from list. Based on the type selected, the screens are dynamic and prompt for information specific to the type selected.
6. Choose your Payor Source by clicking on the ‘three dot box’ and selecting the correct insurance from the list. This will populate the Supply Billing field.
- The correct Admission Source information can be pulled from the previous payor source information.
- In the insurance info field, if Policy Number (Subscriber ID) is populated, the HICN is not required.
- Fill out the Insured Party Info. If ‘Self’ is chosen, the contact information will auto-populate from the patient demographic information.
- The Payor Source Verification is where information regarding co-pays, deductibles, drug card info, etc. can be entered.
- Ensure the POC Required box is checked.
8. You now need to identify the invoice number for the claim to adjust
- On the Financial Manager workspace, click AR > Accounts Receivable.
- Specify dates that include the original post date of the claim.
- Click on the “three dot box” under the Clients field to locate your patient. Click Apply Selections and then in the AR window, click Load Invoices.
9. Write down the invoice number for reference in claims adjustment window.
10. Next go into R2 > Financial Manager > Per Diem > Claim Adjustment
- For Provider #, choose the corresponding provider and then enter the invoice number copied from the previous procedure.
- Click Load.
- Double-click on the line of the invoice to pull up LOC and Visit Details
- Click to high-light the first line in LOC details, hold down your shift key and scroll to the last day listed and click on it. This selects all the days you are going to reset to bill the new payor.
11. Now Right click anywhere on the high-lighted blue details and choose “Edit Selected Rows” this pulls up the “Multi Update Tool”
- Check the box under Status, then from the drop down list, choose “Reset Level of Care” then click the Update button to save.
- Back in the Claim Adjustment window, click Close.
12. You will now need to address the old payor source in order to generate a claim for the new payor source. Go back into HCHB > Clinical Input > find the episode and double click.
- Click on the payor source tab.
- Double click on the line of the old payor source.
- A warning will pop up; telling you this payor source cannot be edited.
- Click OK.
- When the payor source window appears, click on the radio button titled, Informational Only.
- Click Save to close the window. Close out of the client information window.
13. You can now go to the Per Diem -> Claim Management to generate a new claim with the newly added payor source.