Using Daily Recurring Charges And Special Billing Rates

In Health Center Billing, some residents require daily recurring charges and/or special billing rates. These will be successfully generated if you do the following:

1. For daily charges, the Daily Recurring Charges file will need to include the resident's ID # and the proper information for the charge. Note: If you would like this charge to be incurred for an undisclosed amount of time, enter 12/31/2051 in the Through Date field.
   
   For Daily Recurring Charges, the charge will bill according to the way the billing code is set up. If the charge is set up as private only, it will always bill as private but if the person changes from private pay to Medicare or Medicaid and the billing code is set up to bill Medicare and/or Medicaid, it will bill one or the other. Medicare will take precedence over Medicaid if the billing code is set up for both and the resident's payer type and census indicate that he/she is eligible for both.
   
   The Daily Recurring Charge entry must have a beginning date. If the charge is to change rates in any given month, another daily recurring charge can be added for the same billing code but with the start date after the end date of the previous charge. If the charge will change in the next billing month the amount of the current entry can be changed after the Generate Monthly Billing option has been run. Generate Monthly Billing is what creates this charge. These charges can be for goods and/or services. Some examples are: Depends undergarments, dressings, insulin, meals, etc.
   
   
2. The Special Billing rate is usually for a resident who is private pay, is on a contract and has been transferred, either temporarily or permanently from Independent Living to the Health Center. If the resident becomes eligible for Medicare A during that time, then Medicare will take precedence, otherwise the amount in the Rate Master file for each census day will be overridden by the amount in the Special Billing Rate. If the person's billing rate changes during a billing cycle, then the second column of the Special Billing Rate screen can be filled in with the starting date after the ending date of the first column. The Special Billing Rate must have start and end dates in order to function. The end date will normally be far in the future unless an end date is known; such as the end of a lease, for example. Normally only the left column would be filled in. If for some reason the rate is to change after the current month, then the rate in the first column can be changed after the Generate Monthly billing has been run and before the pre-billing has been run.
   
   
3. Special billing rates are room rates for residents who should be excluded from the Rate Master File. To activate this option for a resident, enter the proper information in the Special Billing Rates Master File. Each resident is allowed up to two daily or monthly special billing rates at one time.
   
   
4. Make sure that the daily census has been run for each day of the month.
   
   
5. Generate billing as usual.

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