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  3. Billing (Configurations) Utilities

Encounter Billing Preferences

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Encounter preferences can be customized for each individual provider and billing staff member, allowing for a tailored approach to managing billing processes. These preferences enable healthcare organizations to align the system with each team member's unique workflow and responsibilities, enabling greater efficiency for your practice. Although this information is set by default, you have the option to edit it directly within the encounter screen. 

Access encounter preferences

CBO users can set Encounter Preferences for each practice they bill. To help distinguish CBO accounts from non-CBO accounts, their login will appear with a (Corp) label in the dropdown user menu. 

Start by navigating to the Utilities. 

Select Preferences, then click Encounter Preferences. 

Encounter preferences

In the Encounter Preference screen, approximately 17 distinct types of preferences can be configured as default settings. 

Provider default settings 

Display Encounter values from Default Settings
This setting should always be enabled, as encounter preferences will not be applied unless this option is selected. When toggled on, it ensures that all configured encounter preferences are properly implemented, allowing for a more streamlined and accurate encounter process. If left off, the encounter preferences will be ignored, which may result in inconsistencies, errors, or incomplete data. 
Default Billing Provider
The Billing Provider selected here will automatically be applied to all encounters. This setting is primarily used when a user is billing under a specific billing provider. 
Default Rendering Provider (EHR Encounters)

The Rendering Provider selected here determines the default provider on encounters released from the EHR.  

If you select “Matching Licensing Profile Provider” please note the following:

  • When an encounter is released from the EHR by a licensed rendering provider, the system will match the user to the rendering provider license, and select them as the rendering provider for the encounter. 
  • If the user creating the encounter in EHR does not have a rendering provider license, no default rendering provider will be selected on the encounter in billing. In this case, the user should manually select the appropriate rendering provider from the dropdown list. 

Example: If Maryland Doctor is the user who created and released the encounter from the EHR, and is also a licensed rendering provider in Billing, the system will automatically default him as the Rendering Provider on the released encounter when 'Matching Licensing Profile Provider' is selected.

However, if Maryland Doctor is the user who created and released the encounter from the EHR, but IS NOT a licensed Rendering Provider in Billing, he should not select 'Matching Licensing Profile Provider' as he does not have a Rendering Provider license, and should instead select the appropriate provider from the dropdown.

Keep in mind that you can hover over the information (i) icon to view helpful tooltips or additional context about the field or setting.  
Default Supervising Provider
The Supervising Provider selected here will be automatically applied to all encounters. This is set to a specific supervising provider when a user is billing under that provider. 
Default Rendering Provider (Manual Encounters)

The provider selected in this setting will automatically be set as the default Rendering Provider for new encounters manually created in the Billing product. Example: When a user manually creates an encounter in Billing, the selected provider will populate by default.

Keep in mind that you can hover over the information (i) icon to view helpful tooltips or additional context about the field or setting.  
Default Referring Provider
The Referring Provider selected here will be automatically applied to all encounters. This is typically set as a default when a user is billing under a specific referring provider.  
Default Attending Provider
The Attending Provider selected here will be automatically applied to all encounters. This is typically set as a default when a user is billing under a specific attending provider. 
Default Operating Physician
The Operating Physician selected here will be automatically applied to all encounters. This is typically set as a default when a user is billing under a specific operating physician. 
Default Other Operating Physician

The Other Operating Physician selected here will be automatically applied to all encounters. This is typically set as a default when a user is billing under a specific operating physician. 

Default Scheduling Provider
The Default Scheduling Provider option is only visible and available when the company preference “Scheduling Provider on Encounter” is enabled. Once configured, the selected provider will automatically populate on all encounters that are created or imported into Billing.

Encounter default settings

Default Service Facility Location
The Service Facility Location selected here will be automatically applied to all encounters. This is primarily used when a user is billing for a specific service location. 
Default Claims Format
When selecting either the CMS-1500 (professional) or the UB-04 (institutional) claim format, every encounter will automatically default to the corresponding screen. The system adapts based on the chosen claim type, simplifying the workflow, and ensuring that the correct format is used for every encounter. 
Default Discharge Status
Selecting a discharge status from the drop-down menu will automatically apply this selection to every encounter for UB-04 (institutional) claims. 
Default Admission Type
Selecting an admission type from the drop-down menu will automatically apply this selection to every encounter for UB-04 (institutional) claims.
Default Admission Source
Selecting an admission source from the drop-down menu will automatically apply this selection to every encounter for UB-04 (institutional) claims.
Show Condition Codes in Professional Encounters
This setting gives users the ability to add a condition code directly within the professional encounter screen. Condition codes, while typically used in institutional claims, can also be incorporated into the CMS 1500 encounter screen. When enabled, this functionality allows users to document relevant condition codes for professional services, ensuring more accurate and comprehensive claim submissions.
Default Copy Patient's Last Encounter Details

When this setting is enabled, the system will automatically populate the patient's previous encounter information whenever a new encounter is created. This feature streamlines the documentation process by pre-filling relevant details, such as diagnosis codes, procedure codes, and any other associated data from prior encounters.

 

Diagnosis settings

Enable Add Diagnosis
Enabling the add diagnosis feature provides users with the ability to include more than four diagnosis codes per line item, allowing for up to twelve diagnosis codes per claim. This functionality is essential for situations where multiple diagnoses need to be documented to accurately reflect the patient's condition. However, to use this feature and exceed the default limit of four diagnosis codes, it must be manually enabled. Once activated, users can add additional codes as needed, ensuring comprehensive and precise documentation for each encounter. 
Show All Diagnosis in Claim
Enabling this option ensures all diagnosis codes that appear on the encounter screen will automatically be included in the claim and sent to the payer. If not enabled, only the diagnosis codes added to line item(s) will appear on the claim form. 
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