This document will show you how to process workflow for Room and Board in HCHB. It will also highlight those critical steps where you need to make sure you understand what you are chosing. Please always consult your Resource if you are unsure of what options to choose at those critical places.
Please note, these instructions are for those Hospice patients that have:
- A Payor Source that allows for Room and Board (must have authorization for Medicaid Room and Board)
- Patients that are at a Service Location that is eligible for Room and Board such as a SNF (ALFs are NOT eligible for R&B Billing).
When you double click on this task you will see a window like this that opens up. Please consider the following before processing this. If the answer to either of these is NO, you can click the No button for this workflow and you are finished.
- Please double check that the patient is in a SNF (ALFs are not eligible for Room & Board billing)
- Please check that they really do have authorization for Medicaid Room & Board. Please choose carefully here. You can cause some havoc in billing if you choose the wrong option here. Do not pick something just to get this workflow cleared. This is an important task!!
Please choose carefully here. You can cause some havoc in billing if you choose the wrong option here. Do not pick something just to get this workflow cleared. This is an important task!
If the patient is eligible, you need to set up a secondary payor in the Payor Source Tab in order for Room and Board Rates to be entered by the billing department. Please do not chose YES on this workflow until you have followed the directions below if the patient IS eligible for Medicaid R&B. Also, please do not process the Setup Room and Board workflow; this is a function of the billing department.
Instead of Double Clicking on this workflow, right click on the workflow line and choose Client Information.
- Go to the Payor Source Tab
- Click the Add Payor Source Button
When this window opens, make sure to...
- Choose Secondary
- Choose Medicaid
Once this is you have chosen Medicaid, another window will open.
The 2 required fields here are the
- Point of Origin and the
- Medicaid Number.
You will not be able to save this if you do not enter that information. Once entered, hit save. You will see it on the Payor Source underneath the original payor source.
Please make sure that this shows up in the secondary spot.
Be sure to obtain/enter authorization information if pre-auth is required in your state!