Advanced – System Information

RescueNet Billing
Administrative Tune Up
BJ Terrill
This Session is CEU Approved
Tune Up Your System!
Advanced functionality of RescueNet Billing is set up when
your implementation specialist is onsite – and this may have
been a few years for some of you.
• Some of the areas that we will look at today are:
• Profit Centers
• ICD9 codes
• Facilities
• Denials
• Payors
• Charges
• Schedules & Workflows
• Advanced System Information
Profit Centers
Profit Centers are used to group trips for reporting purposes.
• Track profits by station
• Track mutual aid
• Track resident vs non-resident trips
Month end closing reports will group charges and credits by
Profit Center before summarizing all charges and credits at the
end of the report.
Profit Centers
From the Company screen, click on “Profit Centers”
Profit Centers
Click on the “Add” button; now add the description of your new Profit Center
And click on the “OK” button.
Profit Centers
You will see your new Profit Center in your list. You can immediately
begin using this.
Profit Centers
Once a period is closed using “Close
Accounting Period”, the Profit Center is
“locked” onto the trip. If you need to
change the Profit Center, use “Update
Profit Centers After Closing” . This is
available in Administration/Advanced, Run
Profit Centers
Enter trip year, then run #.
The trip’s current profit center
will display. Change to any
existing profit center.
ICD9 Codes
Do you have ICD9 codes you no longer use?
You can “expire” these codes.
Add expiration
date here.
ICD9 Codes
Do you have payors that require different
complaint codes?
Override here!
Some facilities have departments within
them – an example would be a hospital
that has a dialysis department within it.
Don’t add a second facility – just add a
department within that facility that has the
correct modifier.
Click on Departments
From this screen,
add the description
and add the correct
The correct
Is selected
The Billing screen
reflects the correct
modifier for a hospital
based dialysis center.
Default Charges
Are you using Default Charges??
You can default charges into RescueNet Billing
based on Company, Call Type and Response Priority.
Also, Billing Zone is an option if you have the zoning
Charges can also populate from ePCR – let us know if you
like additional information.
Default Charges
In this sample, an ALS
Emergency call would
automatically add base
rate and mileage to the
trip in RescueNet.
Default Charges
Notice that the “default” column shows the base rate and mileage
have loaded from what was set in Default Charges; the oxygen
charge was added by the biller.
Payor Specific Overrides
If you have contracts with certain facilities,
you can set up those adjustments ahead of
time, then when you add a trip for a patient
from that facility, the adjustment will be done
This is the same area where you add
Medicare and Medicaid contractual
Payor Specific Overrides
From the “Edit Charge” screen, go down to
“Payor-Specific Overrides” and “Add”.
Payor Specific Overrides
Select the payor, then click on “Add”.
Payor Specific Overrides
Add the amount you expect from that payor. If the payor uses a
different HCPCS Code (some payors do…) you can override that
value here.
Payor Specific Overrides
Last step is to select which contractual allowance is to be used .
Payor Specific Overrides
One adjustment was done by the system and one was done manually.
Mileage Ranges
We can set up RescueNet so that it can charge for
mileage based on the number of miles. This is also
set up in Payor Specific Overrides.
Mileage Ranges
Click on the
“Add” button
to enter mileage
Mileage Ranges
“Add” the expected amount for the mileage range.
Mileage Ranges
You can add multiple values here.
Mileage Ranges
Per the mileage range, mileages less than 10 miles are charges $0.00, per mile.
Here, the total mileage is 6 miles; so the resulting charge is $0.00. Notice that
the quantity is 6.0R. R indicates that a “range” is being used.
Mileage Ranges
Keep in mind – if your trip encompasses
several different ranges, RescueNet does the
calculations behind the scenes and will add
just one line item for these different mileage
Automatic Denial Posting
You can have RescueNet automatically move
trips to a denial schedule once a denial has
been posted to a trip.
Automatic Denial Posting is located under
Credits and Denials.
You need to start by creating a schedule for
your denied trips to move to.
Automatic Denial Posting
Now – just select the payor type, then select
which schedule and event to move them to.
Automatic Denial Posting
You can also set up payor-specific denial posting overrides.
Automatic Denial Posting
You can select a payor, a specific denial reason
and a specific schedule to move the denied trip to.
HIPPA Denial Codes
Many payors do not use the HIPPA Denial codes, but
substitute their own. So a HIPPA code of PR96 may turn into a
AET45 from a payor. It is suggested that you try to find the
HIPPA denial code and use that when posting denials. When
using the substituted codes, then submitting to the next payor,
that next payor may not recognize the code and deny the claim
For instance, if Medicare is secondary and you have added a
denial code of AET45 for a PR96, Medicare will deny.
You can print a Denial Code list from RescueNet Reporting,
then use that report to cross reference.
Payors – Advance Verification
What does “Require Advance Verification” mean?
By checking this box, the biller is required to
verify (F10) the trip before It can be billed.
Payors - Inactivate
How do you “inactivate” a payor and what does it do?
When you check this box, the payor will no longer show in a drop
down list, so it can’t be selected by a biller (if “Show Inactive” is
NOT checked on the payor drop down list – suggested!).
Payors - Inactivate
This is the “Show Inactive” on the payor drop down – when this is
“unchecked”, the biller will NOT see the inactivated payors.
Auto fill
Auto fill is a unique feature that allows you to
process credits on multiple trips at the same
If you batch-bill a facility and they return a
payment for that Batch, you can use Auto fill
to post those credits.
Auto fill is part of Batch Credits and can be
accessed from the Call Taking screen by
pressing Ctrl+B.
(Not available in Batch Posting at this time.)
Auto fill
Click on “Open” and select “Auto fill
Auto fill
Here, I’m going to post a check
for a batch that was billed out.
I have entered the batch number
and also the credit I am using.
Note: You can always use Batch
History to find that batch number!
Auto fill
The batch is loaded, shows the total credits to be posted, and the
“Post Batch” button is available.
You are able to edit or delete these credits if needed before posting.
Auto fill
I want to write off all
balances that are under
I have selected the credit of
“Write off Small Balance” and I
have only included trips that
have a balance of less than
Auto fill
These trips will be “written down” to zero with
“Write off Small Balance” credit.
Advanced – Run Process
Mass Payor/Schedule Move
You may need to move multiple trips from one payor to
another or one schedule to another. This utility will
allow moving all those trips at once rather that opening
each trip and making that change.
Advanced – Run Process
Mass Payor / Schedule Move
In this example, the patient’s trips
were billed to insurance and then
denied with no benefits remaining.
So all those trips are being moved
to a “Bill Patient” schedule.
If you add a “reason”, that will be
copied to each trip that was moved.
If you have not used this utility before, please
call Support to assist!
Advanced – Run Process
Mass Payor / Schedule Move
You will see a list of the trips that match your criteria. You may
“untag” trips from this list that you don’t wish to be moved.
Advanced – System Information
General Tab
Are all the “History Events” turned on?
Change number of lines when previewing notes to “6”.
Advanced – System Information
Billing Tab
If the “set in collections on the schedule is
“unchecked”, the trip will no longer have the
collections box checked on Billing Tab 3.
Advanced – System Information
Billing Tab
If the “set in collections on the schedule is “unchecked”, the trip
will no longer have the collections box checked on Billing Tab 3 .
Advanced – System Information
Billing Tab
This option allows the biller to change the charge amount on a
specific charge. When this is used, the biller will be required to
select adjustment code.
Advanced – System Information
Billing Tab
In this example, the Gross
Amount per unit has been
changed. An “Adjust as”
credit must be selected
from the drop down list.
If you have the Security
Module, this would be
enabled there. If not, the
Administration setting will
enable it.
Advanced – System Information
Billing Tab
This would be the results of that transaction.
Advanced – System Information
Billing Tab
CMS and other carriers have changed the calculation of
allowable amounts for mileage to go out to three decimal places
which can cause a discrepancy when billing secondary claims.
You can default a credit to use when importing remit files.
Advanced – System Information
Billing Tab
Use this option in conjunction with Workflow to ensure that
billers only see trips that have been through your pre-bill
Your process might be
• The pre-biller verifies insurance coverage for the patient
• The pre-biller then checks the “Pre-billed” box on Billing Tab 3.
• The biller runs a workflow that checks for the Pre-billed box
and the trip will display only if the box is checked.
Advanced – System Information
Billing Tab
Part of the verification process might be adding the date that
you checked eligibility and also noting if that eligibility has an
expiration date. This is done on the customer, by editing the
Advanced – System Information
Billing Tab
In that same area of the payor, you can also enter eligibility dates.
So – if the customer is not eligible for coverage until June 1st, that
date can be entered here.
This will actually stop you from using this payor until the customer
is eligible.
Advanced – System Information
Billing Tab
Pre-billed box that needs
To be checked when
Pre-bill process is complete.
Error when attempting
verification on trip where
Pre-bill box has not been
Advanced – System Information
Billing Tab
When adding your workflow filter, be sure
to select “Yes” for the Pre-billed box.
Advanced – System Information
Billing Tab
When adding charges
manually and you don’t
know the category, just
select the “Charge” drop list
to see all of the charges set
up in RescueNet.
Advanced – System Information
Billing Tab
When importing an 835 file
from Medicare that has
interest payments on it,
allow RescueNet to add
interest charges to the trip.
You will need to set up an
“interest charge” in
RescueNet charges with
System Code of “Interest”.
Advanced – System Information
Billing Tab
These are the only defaults ever suggested. (“Chair Confined
During” is set to “no”, if your agency does not do Wheelchair
Advanced – System Information
Call Taking Tab
You can decide whether to allow billers to “Uncancel” trips and to
“Cancel complete trips”.
When a new trip is added, you can “recall” company, ICD9
codes, payor and personal doctor.
Note: These settings can affect Dispatch as well – take care!
Schedules and Workflows
Workflow is the “ONLY” means you have
of knowing what trips are in which schedules.
Schedules and Workflows
have to work together!
Schedules and Workflows
Begin by reviewing your list of schedules
• Do you know how many trips you have on
each one of these schedules?
Start by opening one of your schedules…
Schedules and Workflows
Do you know why some of these drop-down arrows are grayed
out and some are not? This means there are trips associated
with the events of “No Bill Sent” and “Sent to Insurance”, but
none have moved to the “Phone Call Event”.
Schedules and Workflows
In my example – I want to see how many trips are on the
Clearinghouse Schedule and on the event of “Phone Call”.
I want to make those phone calls!
Schedules and Workflows
Workflow is set up so that it will display any trip that has the
status of Complete, Billed or verified, is on the
Clearinghouse schedule and the event is phone call.
Remember to “share” if needed!
Schedules and Workflows
What is “Share”?
On the bottom of the Workflow screen, you can
share this filter with others by checking “Make this Billing
Filter visible to everyone”. Also “Summarize this Billing Filter
on RescueNet Billing Today” will add this filter to your billing
Schedules and Workflows
Press F12 and
you will have
access to
RescueNet Billing
Today. You will
see any filter you
have selected to
show here.
Click on a filter, you will see a box showing the date range of those
trips. Click OK and your trips will display in Workflow.
Schedules and Workflows
Now, you can easily see the phone calls that need to be made.
Schedules and Workflows
Let’s review what the “next event date” means.
• If “next event date” is equal today’s date:
• Actually needs attention today
• Has moved to an event that does not require a
form to be printed such as a phone call
• Form is waiting to be printed today
• The schedule does not move forward to a new
form and event; it dead ends
Schedules and Workflows
 Watch out for “account review”
 Supervisor review
 “On Hold” schedules
• Anything that “ends” with no additional forms and
Schedules and Workflows
Go through your list of
schedules create Workflows
and see what is out there that
might be past due and in
need of attention!
Administrative Review
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