Reset Ins Billing

Reset Billing will restart the billing at a specific insurance level if selected while on a visit with insurance,  or restart the Self-pay billing if selected while on a Self Bill in the Billing View.

If you change or add an insurance plan, you need to reset the billing so the system will recognize the new plan and generate a new claim.  The old claim "billing record" will be closed.  Since the reset billing will be a new claim the aging will restart if there were previous claims open.  Important:  The Reset Billing option resets the ENTIRE visit, not a particular charge(s) on a visit.

From the Ledger, Reset Billing may be performed from the Charge/Payment, Activity, or Billing Views by either right-clicking to invoke the pop-up menu, or selecting the Options button at the bottom of the screen.  You may also Reset Billing from the Follow-up Wizard.

Reset Billing - Insurance

Once you select the Reset Billing option, select the Coverage Type: Regular, Workers Comp, No-fault Auto or Other.  As noted on the screen, if necessary, you may change the coverage type here. However, please note that charges will NOT be recalculated with new billed or allowed Fee Schedules, Rate Structures, Units, Quantities, etc. If you wish to update these fields, you must Reverse, Reissue, and Re-post the Visit using the appropriate Coverage Type.  Reset Billing will, however, update the Medical Direction modifiers to the ones required by the new plan, or remove the modifiers from the MD and CRNA modifiers if the new plan does not use Medical Direction modifiers.  Reset Billing will remove the visit from Collection Turnover (if it is in Collection Turnover).

A red message is displayed in the Reset Billing screen beside the "Force Refile To" field alerting the user that leaving the field BLANK will allow the system will file the new claim according to the Patient Insurance Setup.  The user should only utilize the Force Refile To field if OVERRIDING the plan setup.  For example, if a plan is set to file claims electronically but you need to attach additional documentation to have the claim paid, select PAPER in the "Force Refile To" drop down.  In most instances the user should leave this field blank to file the claim according to the plan setup.

Select the insurance plan to reset the billing on and then choose OK. The Billing View of the ledger will display a new claim billing record in light blue as un-posted.  This means the new claim will generate in the nightly closeout.