Learning a new billing process isn't easy, considering the many components and steps required to successfully submit a claim. HHAeXchange is here to help! In this guide, we'll simplify the billing process by breaking it down into easy-to-follow steps, empowering you to confidently bill in no time.
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Where do I start?
First, we begin by preparing the billing information in the system. In this phase, we verify to confirm that essential requirements and information is in place (such as Payer, Service Codes, Rates, matching Disciplines, Diagnosis Code, etc.).
For additional billing guidance, refer to our guide 6 Essential Claim Submission Steps to ensure you have completed all necessary measures to prevent billing holds and delays in the process.
Steps to Bill in HHAeXchange
1. Call Dashboard
EVV call exceptions must be reviewed and resolved via the Call Dashboard. You can review this functionality in the Call Dashboard tutorial.
2. Prebilling Review
The Prebilling Review functionality verifies that all visit information needed to invoice the visit is completed. This feature finds visits with potential problems that may cause delay, hold, or claim denial if not corrected or resolved prior to invoicing.
You can run a Prebilling Review to check for problems before invoicing visits. Refer to the Prebilling Exception Page topic for steps and instructions or the interactive Prebilling Tutorial.
3. EVV Aggregation Transaction Manager
After addressing any Prebilling issues, it's now time to review the EVV Aggregation Transaction Manager. EVV Holds should be corrected, visits submitted to and accepted by the Aggregator before invoicing. Please use the EVV Aggregation Transaction Manager Interactive Training to familiarize yourself with this process.
You can review the following guides to assist you in resolving any holds:
- EVV Aggregation Transaction Manager Rule Holds and Resolution Guide
- Texas Medicaid & Healthcare Partnership EVV Visit Transaction Rejection Guide
4. Create an Invoice Batch
Once all details have been corrected for potential problems, you can invoice those visits. In this phase, you will create what is called a "billing batch". Review the New Invoice Batch (Internal) topic to access the steps and instructions to create an invoice batch.
You can view the Invoicing demo for a helpful video demonstration or practice in the interactive Invoicing tutorial.
5. Billing Review
The Billing Review feature is another essential step to verify that all invoices meet payer requirements and that all necessary information is captured to bill in the system. Refer to the Billing Review topic in the Knowledge Base for details and instructions.
Watch the Billing Review video demonstration or visit the interactive Billing Review tutorial.
Pro Tip: The system does not allow the e-billing of claims until all holds are resolved. Refer to Billing Review Problems and Resolutions for guidance.
6. Electronic Billing (e-Billing)
Now, you're ready to bill! The final step is to send claims to the Payer via the system e- Billing process. Please refer to the links below to avoid EVV claim mismatches before submitting the claims:
- Resource: Best Practices to Avoid EVV Claim Mismatches
- Resource: HCS and TxHmL Best Practices to Avoid EVV Claim Mismatches
Review the Create a New Claims Batch topic for e-Billing steps and instructions and view the e-Billing video demonstration for additional guidance.
7. Congratulations!
Your invoice batch was sent to the Payer for adjudication and further process.
8. Claims Status Check
Please allow approximately 48 hours to see the status in HHAeXchange or Texas Medicaid & Healthcare Partnership (TMHP) application. Run the Claims Status Report (Report > Billing > Claims Status Report):
- If the status is rejected, then the rejection reason(s) is listed under the Claims Status Reason column.
- If the status is not available after 48 hours, then submit a ticket via the Client Support Portal with the subject link “TX Status Not Found.”
9. Claims Status Check
If you need to resubmit or rebill claims for any adjustments or denials, please refer to the Rebilling (Resubmit Claims) topic or the interactive Rebilling tutorial.