Third Party/Patient Billing:

• Online/Batch charge entry
• Flexible billing cycles
• Flexible claim formatting (CMS 1500, UB04's, 837 transactions)
  
• Online reformatting
• Detail charges, payments / adjustments
• Missing element tracking
• Claim hold
• Online financial history
• HIPAA electronic transactions. Click here for a complete list of supported transactions.

Facility Billing:

• Monthly facility invoices
• On-demand invoices
• Invoices can be viewed online
• Multiple contract types per facility
• Automatic facility charge posting
• Post payments/adjustments to the patient's charge
• Online status of outstanding patient charges
• Online financial history

Demonstrations:

Only one demonstration can be open at a time. After viewing a demonstration, close down the window to return to this page.

Reverse a Charge (2.55 minutes)

Online Financial Folder (4.07 minutes)

Review and File a Claim (3.10 minutes) Note: the demonstration shows the old HCFA form but PDM supports the new CMS form as of 5/23/07

What PiMS Medical Billing will do for your office

• Permit you to customize billing cycle parameters and modify billing forms to conform to third party requirements.
• Automatically generate a rebill, as well as a supplemental or adjustment bill, as required by the third party.
• Automatically link billing of separate accounts per third party requirements (i.e. combined billing for a mother and baby).
• Provide an on-line view of the physical claim/patient bill form, and a complete history of the charges for an account, claim, or patient bill.
• Provide an on-line update of billing codes and allow you to revise charges to reflect changes in codes, quantity of charge items, or service date.
• Hold the account, claims, or patient bills while monitoring and correcting claim formatting problems on-line.

Charge Posting

Billing and Collections offers both immediate and batch posting options.Charges can be instantly posted to an account or they can be set aside for nightly batch processing.

Billing and Collections effectively matches charges with proper accounts to meet a variety of third party billing requirements: pre-admit charges billed with inpatient stay, newborn charges billed on mother's account, and overlapping accounts billed according to the 72 hour rule.

Room and bed charges are automatically generated and automatically adjusted for things like changes in accommodation type.

Smart Claim Generation

When a billing event occurs, Billing and Collections evaluates third party requirements to ensure the appropriate claims are generated. The expected reimbursement is then calculated and any remaining balance transferred to secondary claims, or to the guarantor. When late charges are billed, a claim can be automatically re-formatted or re-billed, or a upplemental claim can be generated.

Customize Your Billing Cycle

Customize your billing cycle by defining the criteria for various "billing events" (interim bills, final bills, late charges, small-balance write-offs, etc.). For example, final billing can be based on a designated number of days from the close of an account; late charge billing can be based on a combination of balance threshold and the number of days from the last bill

Electronic Claim Submission

As claims are filed PiMS tracks them in our Electronic/Print file. At a scheduled time or when requested by a user, PiMS will create a file that can be uploaded to the clearinghouse.  

ENS Electronic Network Systems

PDM works with ENS Electronic Network Systems to provide a web-based 837 (institutional and professional) claims submission service. ENS provides a full suite of services designed to streamline workflows between providers and healthcare payers.  ENS services enable you to perform all of the payer-mandated HIPAA transactions in one place. ENS services are designed to integrate well PiMS.

For more information, refer to the ENS website, www.ENSHealth.com.

Other Clearinghouses

PDM has worked with a variety of clearinghouses and will work with the clearinghouse of your choice. 

Claim Management

With Billing and Collections, you can complete, re-format, re-bill, deny, print, or cancel claims on-line. Mail-ready claim forms can be printed right from your desk.

Reimbursement

Reimbursement for claims is conveniently prorated based on remaining days and coverage, percentage of coverage, and any out-of-pocket requirements. Once the primary claim has been paid, any outstanding balance is automatically transferred to the guarantor, or to existing secondary claims
and the secondary claims released.

Payments and Adjustments

Billing and Collections lets you post payments and adjustments to the account, guarantor, or claim, providing an accurate view of your account receivables. For insurance payments, 835 remittance transactions can be posted automatically.

On-Line Financial History

Take advantage of the complete on-line history of financial activity for an account. This includes charges, financial notes, claims, and patient bills - all in the exact format of a hard copy. A simple click of the mouse provides an informative summary - the central point for an account's financial position.

You can also access on-line notes, which provide a history of account activity as it relates to the patient, guarantor, and third party. These allow separate departments within the financial service area to be apprised of an account's status. The financial folder is no longer needed!

Brochure:

Download the Billing and Collections brochure