Billing FAQs

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When sending claims electronically, a Contact Employee (or Employee # For Signature if printing claims) is chosen from a drop-down menu. This field is populated with the person doing the billing and the system pulls the phone number from this user's profile. 

To add the Agency phone number to the person who is doing the billing for your Agency:

1. Navigate to the Employee / Contractor List: Maintenance and Setup > Employees > Employee/Contractor > Employee/Contractor.
2. Select the Employee that does the billing for your Agency.
3. Click the Ok button.
4. Click the Edit button.
5. Add the Phone number for the Agency on Page 1.

You will need to add the Agencies and their associated Tax IDs to the system by following the instructions here. After your Agency is added, make sure to set the Service Rates for your Activity Codes by following Step 2: Add Activity Code Service Rates.

If you have clients in the system with a Client Insurance record already complete for a specific Payer and then you update the Master Insurance Form for that Payer to require Prior Authorization, the Prior Authorization Required checkbox in the Client Insurance record is not automatically checked. This will not retroactively update the clients for who you already completed Client Insurance records for and you will need to update the individual Client Insurance record.

1. Navigate to the Client Insurance Form: Navigation Form > Client Insurance.
2. Search for and select the client.
3. Select the Insurance Name.
4. Click the Edit Insurance button.
5. Click the Page 2 tab if you use VFO or Page 3 if you use the VPO Billing Engine.
6. Click the Edit button.
7. Select the Prior Authorization Required? checkbox.
8. Click the Save button.

A Print Status of Y (Yes) means that a Line Item is ready to be picked up in a batch of claims to be sent out electronically or printed to paper.

A Print Status of N (No) means that a Line Item will not be picked up in a batch of claims or printed.

A Print Status of S (Sent) means that the claim file has been created and you will need to update this status to an "N" so that it's not picked up to be sent or printed again, click here for more details on that workflow. 

A Print Status of R (Resubmit) means that the Resubmit button has been clicked on the Line Item Form for a specific Line Item. 

Any claims with a Print Status of Y, S, or R will be picked up in a batch of claims to be printed or sent if the Line Item matches the criteria you are searching for. It is important to note, that Line Items need a print status of "N" to be able to post payments. Therefore, you typically will be using the Print Status of "Y" and "N" the most in the system if following best practice recommendations.

Selecting the Simplified AR Report checkbox in the Accounts Receivable report creates a simplified report that shows charges at the Service Level rather than the Insurance Payer level. If the Simplified AR Report checkbox is not selected, a non-simplified report shows charges at the Payer Level.

Example: If there is a $100 charge with a $20 copay, the simplified report shows $100 charged (no payer info), and the non-simplified shows $100 to insurance and $20 to the client as two different charges. There are adjustments that make up the difference, so the net should be the same in both scenarios.

In the Employee/Contractor Form in NSS Billing, the security level S = Supervisor, and any user with this designation can change configuration options in the system and delete Line Items. It is recommended that this only be used for a Supervisor/Head Biller.

For all other users, leave this field blank and they will not have the ability to change configuration options or delete Line Items.