Webinar 4: Insurance & Billing Basics

Luminello University

Learn how to easily manage your billing and insurance claim submissions.

Transcript of the webinar

Melissa: Hello everyone, and welcome to the Insurance and Billing Basics Webinar. Thank you so much for joining today. My name is Melissa, and I will be today’s facilitator. Cynthia has joined us today as a panelist as well. She will be available to answer any questions that come up throughout the session. Feel free to type them in the Q&A chat section. At the end of the webinar we will also have a few minutes to answer any questions that come up. All right, let’s get started. 

Our Goal:

Our main goal for this webinar is to review some basic billing features, and show you the steps to start submitting insurance claims through Luminello. 

Overview:

Here we have our overview of what we will be reviewing throughout this webinar. We’ll start talking about billing basics. Showing you:

Billing Basics:
  1. How to setup billing codes and add your practice information to superbills. 
  2. How to view/add/edit/delete billing transactions.
  3. How to create and send superbills and invoices. 
Insurance:
  1. How to get set up with sending claims through Luminello.
  2. Required prep steps for claim submissions. 
  3. How to submit an insurance claim. 
  4. What happens after a claim is submitted through Luminello.
  5. How to track your submitted claims.
  6. How to set up your payers and rates. 
Setting up Billing Codes: 

So, let’s get started with billing basics. This is essential to set up billing codes in Luminello before adding billing transactions or submitting insurance claims in Luminello. Now, Luminello comes pre-packaged with the most frequently used billing codes in mental health. But if you want to add additional billing codes, you can go to the “billing code section” located it in your financial tab, then you can click on “add a billing code” and enter the appropriate code and description in the boxes below. Once you’re done, to save your billing code just click on the “save” button, and that’s it. 

In your financial setting, you can check your practice-wide default for billing. For example, in this section you can set your default rate table, hourly rate, billing code, among other default settings for your practice. Those settings can be changed for individual patients as well. To do this, once inside a patient’s chart, you can go into the “billing tab” and then select “settings.” Under settings you can set the default billing settings for a particular patient. 

Adding your Practice Information to Superbills:

Now, let’s review how to add your practice information.  This information would display in your superbills for your patients. To get started, first make sure that you have added your billing and rendering NPI under your “licensure tab.” Then, under “practice info tab” make sure to add your office info and tax ID. Now once you have added this information, the billing and rendering NPI, as well as your office location and tax ID, you can go to your “financial tab.” And from there go to settings. Scroll down to the practice information section and select your default billing and rendering NPI. It will display only if you have already added this. That’s why you need to first add them individually, your billing and rendering NPI, as well as your office address and tax ID, which you would choose from a drop-down. Here you can also set a default message for statements, and a default term for invoices. Once you’re done, just click on submit and that’s it. Your practice information for superbills will be added. 

How to View/Add/Edit/Delete Billing Transactions:

Now, let’s take a look at how to view/add/edit/delete billing transactions in Luminello. To view all billing transactions for a particular patient, you can click on “all transactions.” This is located on the patient’s billing tab. Once you click on all transactions, you will see that all the billing transactions added for this patient will display here. Now, if you would like to view all the billing transactions for your practice, you can click on “all transactions.” Now this is located in your financial tab. Once you click on financial, the first tab that comes up is “financial summary.” And under “all transactions, you will see all the transactions added and this will be for all the patients in your practice. 

So, if you would like to add a billing transaction, you can either go to the billing area in the patient’s chart, or to your practice’s finances, and from there you can click on the orange “add transaction” button. A screen will display for you to add the required information such as the entry type, will this billing entry be linked to an appointment or not, procedure code, modifier if applicable, your fee type, and amount. The amount is pre-filled. This is based on default payment rates that you set up earlier in your billing codes. And they are also pulled up from your most recent billing transactions for this patient. So, if you have received a payment for this transaction, you can select a payment method under the “payment” drop down, and enter the payment amount. And that’s it. Then you can click on “add transaction.” Your transaction will be added and a confirmation message will pop up letting you know that the transaction was added. You can create an invoice from here, and submit an insurance claim as well.

Let’s take a look at editing a billing transaction. To edit a billing transaction, it’s going to the patient’s billing section, from there click on “all transactions” and then just click on the drop down next to the transaction that you would like to edit, then click on edit. You will be prompted to the edit a billing transaction area where you can update any details that you would prefer for this transaction, whenever you’re done, just click on “update” and that’s it. 

To delete a billing transaction, it’s basically the same process. You would click on the drop down located next to the transaction that you would like to delete, and then select delete. A confirmation screen will pop up in this case, if you’re sure that you want to proceed and delete the transaction, just click on “yes, proceed” and the transaction will be successfully deleted. 

Creating and Sending Superbills and Invoices:

Let’s take a look now at creating and sending billing statements, superbills and invoices. Luminello uses have the ability to post charges and generate superbills for their patients. A superbill would generate all billing transactions added for a selected patient. The patient would mainly use a superbill for insurance purposes as opposed to an invoice, which you can create to manage your practice billing. You can also enable “auto pay” for an invoices form in your practice. Let’s take a look. 

To create a billing statement or a superbill, you can go to your patient’s billing section, and from there click on “create superbill.” Here you would be prompted to select a date range for the superbill. And you can leave a message as well if applicable. Below, you can remove or change the order of a diagnosis as they appear on the superbill. This does not affect the patient’s chart in any way. It only changes what appears on the statement. You can also choose to remove the diagnosis from appearing on the statement altogether by simply dragging and dropping the diagnosis into the box to the right. If you want to add a new diagnosis to this superbill, you can do it right here. And when you’re done, click on “create superbill” and that’s it. 

You will see a preview of the superbill with your practice information and billing transaction for the time range selected included. To send this superbill, just scroll down, and you will see an orange “send” button. Once you click on send, a message box will appear with the superbill attached. Here, you can add a subject, and a body, and the patient’s name would pop up automatically since you would be working inside a patient’s chart. Whenever you’re done just scroll down and you will see three options: send, send-add to chart, and draft. If you want to save it as a draft and continue working on it later on, there’s an option to save it as a draft. And then you can either send it to the patient, or send it plus add it to the patient’s chart entry. 

How to create an invoice:

Let’s take a look how to create an invoice. The easiest way to create an invoice is by clicking on the “create an invoice” link that appears in the success notification after a note is signed. This also comes up when you create a billing transaction. You get a success notification with a few links, create an invoice, and submit an insurance claim. So, this would be the easiest way to create an invoice. Another way you can create an invoice is from the patient’s billing section. You can put a check mark on all the transactions that you would like to create an invoice with, and then click on the orange “I want to” select invoice, and click on create new. When creating an invoice, you can add a message if applicable, if you don’t want the diagnosis to show, you can drag it to the right hand side. And below, you can add a new diagnosis, if applicable, and that’s it, just click on “create invoice” to preview the invoice. 

In the invoice preview screen, you can double-check your invoice details such as the transaction that will be added to the invoice, the date, the term, and if you would like to display a comment for this invoice, you can do it here as well. Next, you can click on create, to add this invoice to the patient’s billing, or click on create and send to send this invoice to the patient’s portal. And that’s it. You will be automatically prompted to the patient’s invoice tracker where you can confirm that the invoice was successfully created. 

Invoice Default Settings:

To check your invoice default settings for your practice, you can go to your “financial tab” and from there go to your settings. Under the invoices section, you can set the default settings for invoices in your practice. For example, here you can set it so it automatically takes you to the invoice preview screen right after you click on “create new invoice” from a patient’s billing transaction. You can also control whether patients would be able to see the balance due from invoices in their portal, and if you would like the balance due from invoices shown in your accounts receivable section. Once you’re done setting your invoice setting, just scroll down and click on “submit” and that’s it. 

Setting up Auto-Pay for Invoices Not Paid in Full:

Let’s take a quick look now how to enable auto-pay for invoices not paid in full. Enabling this feature will charge the patient’s credit card automatically for any invoices not paid in full on the due dates. This can be done once you have set up your Bluefin integration, and the patient’s credit card info has been saved successfully in Luminello. There are two ways you can enable the auto-pay feature for individual patients and practice-wide.  

To enable auto-pay for invoices that are not paid in full, for individual patients you can click on “settings” this is once inside a patient’s chart and wants to click on the billing tab you can go to settings. Under the invoices section, just make sure to check the option that says “automatically charge credit card on file on due date for invoices not paid in full” and that’s it. Your changes will save automatically for this one. And if you want to enable auto-pay for invoices that are not paid in full, practice-wide not just for any particular patient, then you can go to your practice settings. Meaning, you go to your “practice tab” and then “settings.” Here under the invoices section, you have the same option. Automatically charge credit card on file on due date for invoices not paid in full. This would be enabled then practice-wide, meaning, for all the patients in your roster. Of course, the patient needs to have added a credit card in their account, and you need to have Bluefin integration in order for this auto-pay feature to work. 

Insurance: Getting Started with Sending Claims Through Luminello:

Now it’s time to talk about insurance. For those of you who don’t take insurance, you don’t really need to stay for the rest of the webinar, unless you have any questions. So, let’s get started with sending claims through Luminello. Once your practice account has been approved by our insurance claims submission partner, Apex EDI, you can submit claims electronically from the billing area with a few clicks and be notified when claims have been adjudicated. The charge billing history gets automatically updated once an insurance company has generated your ERA. And in your unique Apex EDI portal, you will have more advanced functionality like, checking legitimacy, seeing co-pays and deductibles, resubmitting claims, and more features. Let’s get started.

To submit your application to Apex EDI, you can click on your “financial tab” and from there click on “insurance information.” To sign up to start sending insurance claims through Luminello, click on the orange “sign up now” and you will be directed to our partner Apex EDI’s website to fill out your application form and submit it. And that’s basically it. Apex will be contacting you soon after you send this information, to continue with the sign up process. This process typically takes two to four business days. 

Required Prep Steps for Claim Submissions:

Now let’s review what are the required prep steps for claim submissions? Once your account is ready to go with Apex EDI, there is some much information you need to set up in Luminelloto start submitting claims. 

Step 1- Adding your NPI number and office address: 

You need to ensure that your office address and NPI information have been added. You can add this information by clicking on your “account tab” and under “licensure” you can add your NPI number by clicking on “NPI info”. Then you can add your office address from the “practice info tab” by clicking on “office info.” Next, click on “branch info” this is to set up a branch for your office address. 

Step 2 – Setting up a default branch and NPI for all claims submissions:

Setting up a default branch and NPI for all claim submissions:  You can do this from your “financial tab” and then clicking on “insurance”. Once you’re inside the insurance information section, click on settings, and here you can select the default branch address and NPI number for all insurance claims from the drop down. Of course, this can be updated every time you’re going to submit a claim. 

Step 3 – Fill out the required insurance info for each patient:

Filling out the required insurance information for each patient in your practice, you will do this by going to the chart billing section and from there click on the insurance info tab. Each patient has an insurance info tab under the billing section. Here is where you would input the required insurance information for each patient you plan to bill insurance for. You can also have patients complete their part of the insurance information section on their portal accounts. They just have to click on the demographic information, and there is a section called insurance. Here they can fill out their part of the insurance information. 

Step 4 – Adding a billing table for each insurance company:

You can do this by clicking on “billing codes” from your financial section, and from there click on “payers.” In the payers section, you can add your new payer, and also enter the rate that will reflect your desired rates with this payer. 

Step 5 – Record a diagnosis for the patient:

You can do this after you sign your first note. Luminello automatically records the diagnosis and will put that into the claim form for you. And that’s it. Our next topic is submitting an insurance claim in Luminello. 

Submitting an Insurance Claim in Luminello:

To submit a claim, you can click on the “submit an insurance claim” link that shows up after you sign a note. This success notification message also shows up when you add a billing transaction. So, you can quickly send an insurance claim by clicking on the hyperlink that comes up in that success notification. Another option you can use to submit insurance claims in Luminello is going into a patient’s billing tab and selecting the billing transactions that you would like to submit an insurance claim for. 

Once you have put a check mark on each of the transactions that you would like to submit a claim for, just go to the right hand side and click on the drop down, and select “submit claim.” This will take you to a different screen where you can visualize the claim form and the information that gets added automatically. This is pulled from the patient’s insurance information. So, if you don’t have any information added under the insurance information tab for this particular patient, then nothing will automatically pop into the form. 

However, if you have already added this patient’s insurance information under their profile, then the form should get filled in automatically with the patient’s insurance information.  Once you validate the form, you make sure that all the information that was added to the form is correct, you can click on the orange “submit claim” button to send your claim. And that’s it. Now, if for some reason your claim is rejected by Apex, please do not resubmit from Apex. What we recommend is contacting us to find out why the claim was rejected as Luminello cannot really pick up on any changes that you make in Apex, and when the claim is processed, that info will not come into Luminello. So, we suggest you either contact us, or you can create a new billing transaction and try to submit that transaction instead. 

All right, another way you can submit an insurance claim is from your “financial summary” section. Your financial summary section is located in your financial tab. From here, you can search for the patient’s name or chart ID in the search bar, and then put a check mark in the transaction that you would like to submit an insurance claim for, then click on the orange “I want to” select insurance, then select submit. 

What happens after a claim is submitted through Luminello?

Once a claim is successfully submitted, you will see a message displayed below the chart’s billing transaction with the claim number, and the date that the claim was submitted to the insurance. Once the claim has been paid, you will get a message from Luminello where you can go to the billing transaction history directly. There you will see that the patient’s entry is updated to display the date that the claim was paid, and for how much. It should also display the insurance adjustment and patient responsibility. If there is no adjustment or a patient responsibility, then the amount will usually be displayed as zero. 

Tracking your claims:

If you want to track your claims in Luminello, there are two ways for you to do this. To track your claims that you have submitted for an individual patient, you can go inside that patient’s billing section, and from there click on “claim tracker.” Here you will see the details of the claim submitted for this particular patient. You can check on the claims status, there’s a status column, and the balance details will be under the amount column. Now to track your claims for claims you have submitted practice-wide, then you can go to your financial tab, from there click on insurance information, and then go to claim tracker. In this section you will see all your submitted claims for all the patients in your practice. 

You can check the patent’s name under the patient’s column, the claims status will display under the status column, and the balance details will display under the amount column. And that’s it. Let’s say that you click on “filter list” you can filter your claims by status. Submitted claims are those that have been sent to Apex EDI for processing. Paid claims are those that have already been adjudicated by the payer. And bundle claims are those submitted at the same time for a particular patient. Here you can also filter your claims to display by date range, any date range selected. You can choose from the drop down or you can select your own date range manually. All right, that’s pretty much it.   

Questions: We have arrived at the questions section to verify and see if anyone has any questions or concerns that came up with the subjects that we covered today. Feel free to type them in the Q&A chat section. Cynthia and I can review them. If you don’t have any questions right now, that is totally okay. You can send us an email. Our support email is: [email protected]. Again, the email is: [email protected]. Feel free to send us an email whenever you have any questions or any concerns. We will also be sending you this recording to your email so you can review it and get back to us if any questions come up. All right, so I don’t see any questions have been added. I want to thank everyone so much for joining. It was certainly a pleasure conducting the webinar and I want to thank everyone for joining. I hope it was informative and fun and I hope everyone has a great day. Thank you again for joining. Bye.

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