Code/Chart Review #

Description of the feature #

The purpose of this feature is to allow a note to be sent back to the rendering provider, before it has been billed, to review and ensure that the documentation is accurate.

Note:

• This feature can only be used for signed progress notes and for notes with unbilled claims. If the claim has already been billed, this feature cannot be used.
• When a note is sent back for review, it is opened.
• You can only send back notes that are to be billed to Insurance.
• Only the supervising physician of a progress note and members of the billing team can send back a progress note

Reasons for sending back a note #

A note can be sent back based on two reasons

• E/M justification, and/or
• Procedural documentation

Workflows #

There are two workflows for this feature; one for supervising physician and one for the billing team.

Supervising physician #

A supervising physician can send back a note signed by the rendering provider through EMR.

• Go to EMR
• Click on the progress note that you want to send back for review
• Click on the Send Back button

A pop-up appears

• Select either Underbilled or Overbilled
• Select the E/M reason
  • You can write a note for the reason you selected
• Select the Procedure Documentation error, if any
• Click on the Submit button
• The note will be opened
• The Send Back button will turn red and its name will be updated to Sent Back Reasons
• Clicking the Sent Back Reasons button will display the reasons for sending a note back

Billing Team #

Billing team can also send back a note for review.

• Go to Billing > Bills
• Select Office (Insurance) as Bill Type
  • Send Back option is not available for Office(Patient) Bill Type
• Enter any selection criteria for the Bills that you might have like Patient ID, Provider etc.
• Click Apply
• Claims with the specified criteria will be displayed by the system
• Click on the Send Back button in front of the claim that you want to send back for review

A pop-up appears

• Select either Underbilled or Overbilled
• Select the E/M reason
• You can write a note for the reason you selected
• Select the Procedure Documentation error, if any
• Click on the Submit button
• The note will be opened
• The Send Back button will turn red and its name will be updated to Sent Back Reasons
• Clicking the Sent Back Reasons button will display the reasons for sending a note back