Bill End of Episode for PPS Payers

In this document, you will find instructions for billing EOE for Medicare PPS and for other plans requiring Medicare-like billing. Other Non-Medicare PPS payers include Humana Gold Choice and Tricare.

For updates related to 2021 RAPs, we recommend running the process from Reports > Billing > 14.03 > 2021 RAPs before completing EOE claims.  This will match up the episodes with Oasis DocID @@ to update the tracking with exported OASIS and returned 485.  

 Click the Billing button from the Main Menu.

 Click the PPS Billing item at the top left of the screen.

 Select End of Episode Claims.

 Select from the options at the top, middle as needed:

  Select the payer you want to bill from the list in the middle of the screen. Allow some time for the episodes to process.

            **Note: If there are any errors, a list of the errors will appear.

 The number that shows up next to the payer name will depend if you have Completed Episodes Only checked or not.

 The EOE episodes ready to bill for the selected payer will appear to the left.

 To remove EOEs that you do not want to bill:

 Make sure that the list on the left shows the EOE episodes you wish to bill.

 Click the Create Billing button on the right. Wait while the software creates the EOE claims.

 When the EOE batch is complete, a new file has been created.

 Click the Print Details button to print the list of episodes.  A new screen will come up with a print preview.  The serial number (transmission) will appear in the header.  Click on the printer icon to print then click on Close.

 Click the Hide button to go back to the billing screen. Note that the right side of the screen indicates that the create EOE claims is complete.

 If the claims need printed:   Click Print UB04/1500 at the top of the screen.

 Select the payer you created the claims for from the list on the left.

 Click the End of Episode button. The EOE claims will show up on the left side of the screen under the list of payers.

 Click the serial number of the EOE claim you want to bill.

 Click the Print All Claims in This Batch button.

 Click the icon with the printer in the upper left corner to print the claims.

 Click the X in the upper right corner to close the printer page.