Ready To Be Billed
As the name suggests this check box signifies that the claim has all information to be submitted to the insurance. The functionality of this box can vary according to the internal workflow in the clinic. Two variations are defined below to
Variation One – The Provider is also the coder
In this scenario the provider is also the medical coder and he or she makes sure that all the information required from a coding perspective is complete before adding this check box. After which the biller will verify demographic information and file the claim. If the provider feels the coding is not complete – then he or she unchecks this box
Variation Two – Provider is not the coder
Here the provider only completes the clinical note. The Fee sheet is not used by the provider. He or she might or might not enter ICDs or CPTs. Once the provider completes his notes – the biller or coder with the access right reviews the notes and completes the fee sheet and makes it ready to be billed.
Depending on the internal workflow different strategies can be implemented for using this check. There was a ways to implement one more layer for quality verification using the Ready for QC option explained below.
