EHR Billing and Coding

Managing your claims doesn’t need to be a chore.

We offer an integrated case management and EHR billing solution for agencies looking for accurate and efficient claims management.

Our BillingBuilder module allows you to configure billing for dozens of payers; including Medicaid, Medicare, managed care, and commercial payers. Data from your agency’s programs will flow seamlessly from your charts to your billing module. From there, you can generate electronic claims and send them to any of your payers.

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Create accurate claims and send them electronically to your payers.

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Ensure audit compliance by connecting documentation directly to billing.

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Make reporting easier and more efficient with customizable billing reports.

“Without BillingBuilder, billing for services would take a lot of time and staff to generate the bills and reconcile the payments. BillingBuilder generates numerous invoices into batch claim files in only a few, simple steps.”
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Cal Hedigan
CEO,
Community Access
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EHR Billing Features

Billing in the human services world can be complex. Here’s how we help.

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Configuration

Our billing experts work with your team to configure the billing module for your agency. We guide you to build in your agency’s billing rates, procedure codes, billing rules, and program billing information.

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Accurate Claims

Curate a list of locations that includes your program sites and commonly used locations. Staff can select from this pre-established list of locations to streamline their data entry when tracking transportation.

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Insurance Eligibility Checks

Create insurance eligibility files within our EHR billing module. After receiving a response file, you can re-upload to the system to check your consumers’ insurance eligibility. Easily manage your agency’s 270/271 files all in the same place. With our Change Healthcare Clearinghouse add-on, you can also process real-time eligibility checks.

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Claims Submission

Generate invoices and submit claims to Medicare, Medicaid, managed care, and private payers. Submit claims to your payers electronically within the software, or create paper claims if needed. Our batch submission feature allows you to gather many invoices and submit them together — reducing previously time consuming claims submissions to a quick, simple process.

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Custom Billing Reports

Create custom reports to analyze your agency’s billing processes. Use our powerful ReportBuilder functionality to manage your revenue cycles, evaluate your programs, and resolve issues with billing and reimbursement.

Our EHR Billing Process

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Configuration

Our first step is to get a firm understanding of your billing requirements. Combining our nimble billing tool with our billing experts, we will help your team set up the billing module based on the types of payers you bill to, the services you provide, and your billing rates. 

Our team guides you to build your agency’s billing rates, procedure codes, billing rules, and program billing information. Your agency’s electronic chart data will then flow automatically into the module, allowing you to create claims for your services directly within the software saving you time and money.

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Process

Once configuration is complete the magic begins! Our billing tool, BillingBuilder, ensures that services provided by your agency are in full compliance with all types of regulations and allows you to quickly generate invoices for all your billable services to submit them to payers. 

Your claims will be formatted for electronic submission and tied to service codes, accelerating your payment process and reducing the risk of rejected claims. For even more efficient billing, our Change Healthcare Clearinghouse add-on provides direct connections to your payers and streamlined claims submission.

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Reporting

We help your team manage your revenue cycles, evaluate your programs, and resolve issues with billing and reimbursement. The integrated reporting feature enables you to create customized reports on all your billing activities that help you save time and money. 

By connecting all your services to your billing activities, you can ensure consistent auditing compliance, diagnose issues with pending claims, and track program revenue. Never miss a billing opportunity!

Frequently Asked Questions

Good communication between the program and billing side is the first and most important step in preparing for success for billing. The program staff, supervisors, and Billing team need to understand billing rules and what documentation should be entered in a client’s chart to trigger a bill. This is not just about documentation, but making sure things are in place. If you do not know this before billing configuration starts, this is something that will be addressed during the billing configuration. A key portion of success relies on accurate data entry when working with your team.

The Foothold team guides you to build your agency’s billing rates, procedure codes, billing rules, and program billing information for your state or payer. Your agency’s electronic chart data will then flow into the module, allowing you to create claims for your services directly within the software saving you time and money.

If your team is only submitting billing to one payer, then a Clearinghouse is not necessary. Without the use of a Clearinghouse, your team can download the claim file to your device and upload to another portal. If billing for multiple payers, it is highly recommended to have a Clearinghouse. This allows you to control your billing easily with the push of a button. There are certain cases where use of a Clearinghouse is required. As an additional benefit, Clearinghouses will scrub your claim files before forwarding them to the insurance companies for processing.

If you have not received payment for a bill, there may be an error in the file setup. There could also be an error within the client chart data. This includes details regarding the required fields, incorrect provider information, authorization errors, or expired insurance. 

If you were paid the wrong amount, your payer will be able to provide you details on why that happened. What happens most often is that rates change before the payer system is able to be updated. If new rates need to be updated, your team can update the change using our tool to align with new updates. 

Making updates with authorizations is a manual process. If you need to make an update and have not used the authorization record billing yet, this process is very easy through our Entitlements page. For any specific issues or questions relating to changes, our team is here to assist you.

Never miss billing opportunities with our easy and streamlined way to track what is being billed for. We help your team manage your revenue cycles, evaluate your programs, and resolve issues with billing and reimbursement. The integrated report feature enables you to create customized reports on all your billing activities that help you save time and money. By connecting all your services to your billing activities, you can ensure consistent auditing compliance, diagnose issues with pending claims, and track program revenue.

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How Goodwill Discovered
$22,000 in Medicaid Reimbursements

Founded: 1902

Clients Served: 136,000 Annually

When launching a new program, Goodwill took the opportunity to review their entire billing process. We worked with them to identify omissions in their data entry, helping them recoup thousands of dollars in reimbursements.

Our EHR billing and coding features help you streamline your agency’s billing, coding, reporting, and operations.