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.
o Click the Billing button from the Main Menu.
o Click the PPS Billing item at the top left of the screen.
o Select End of Episode Claims.
o Select from the options at the top, middle as needed:
o 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.
o The number that shows up next to the payer name will depend if you have Completed Episodes Only checked or not.
o The EOE episodes ready to bill for the selected payer will appear to the left.
o To remove EOEs that you do not want to bill:
o Make sure that the list on the left shows the EOE episodes you wish to bill.
o Click the Create Billing button on the right. Wait while the software creates the EOE claims.
o When the EOE batch is complete, a new file has been created.
o 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.
o 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.
o If the claims need printed: Click Print UB04/1500 at the top of the screen.
o Select the payer you created the claims for from the list on the left.
o Click the End of Episode button. The EOE claims will show up on the left side of the screen under the list of payers.
o Click the serial number of the EOE claim you want to bill.
o Click the Print All Claims in This Batch button.
o Click the icon with the printer in the upper left corner to print the claims.
o Click the X in the upper right corner to close the printer page.