Lab Autobill Client System Guide

As of GoRev 2021.01.08 the GoRev LIMS natively supports automated capture of charges upon approval of specimens. This module must be activated by the GoRev support team. To request activation please ensure your have worked through the system configuration steps below and then submit a ticket.

System Configuration

Charge Master

A pre-requisite to utilizing the lab auto bill system is to have a configured charge master in place. View this guide if you need help information regarding this module. Charge Master

Configuring your Test Compendium Billing Tab

Navigate to Admin, Configuration, Edit Tests. Select each test you wish to activate an auto billing component on and click into the Billing Tab.

Double click an existing item to edit or click New/Delete as needed. You will be shown a Billing Options UI. Configure the following fields:

Code Type

• Panel = If all tests within a specific panel are present on a result, trigger the panel charge code one time at the result level. Panel mode is useful in scenarios where multiple tests may need to be rolled up into a single CPT code. IMPORTANT - When using a panel code type every test you have put the same panel code on must exist and be resulted on a specimen in order for the panel code to charge. For example, if you put 80053 on the 14 tests included in a Comprehensive Metabolic Panel all 14 tests must be on the specimen and have results when it is approved in order for the panel code to charge to the visit.

• Single = Charge the code for each test present on a result that has not rolled up into a panel.

Both single and panel Billing can be configured on a single test. This is useful for scenarios where you may have a specific panel worth of tests present and have added on a single additional test that in itself does not constitute an entirely new panel. The single test would bill alongside the panel.

Effective Date

This date determines which specimens collected on or after the date will have a specific Billing code applied. This is particularly useful when codes change on a specific date of service. You can leave the prior code in place and simply add the new one with an effective date set appropriate to impact go forward specimens.

AMA vs CMS charge code

These two boxes are instant search off of your charge master (see pre-requisite above). By default the AMA charge code set will be utilized. You can configure this at a carrier level by toggling on the "Prefer CMS Codes" checkbox (see second screenshot below.

This setting is accessible in Admin, Configuration, Carriers, then click Claim Generation tab.

When you have your configuration set on this specific test click Save. Repeat the process on each test in your compendium.

Using Explosive Charges

The lab auto bill system supports use of explosive charge codes. Doing this can allow for more complex charging situations where more than one code of varying quantities needs to be applied. Configure your explosive charge as discussed in the charge master guide. Then use as needed above. We recommend only using an explosive charge in a Panel code setup. Using a single code approach could cause an explosive charge to apply multiple times erroneously.

Reviewing and Releasing Claims

As the autobill system applies codes the claims will automatically move into the AutoBill Needs Review coding bucket.

Review each claim and set to Coding Approved status when ready to generate a claim. You may have scenarios where additional diagnosis codes need abstracted or additional fine tuning of charging needs performed prior to releasing a claim.

Releasing claims can be done in bulk using Reports Bulk Actions

GoRev Support Team

If you have any questions, concerns, or problems regarding this GoRev Tutorial, please contact the GoRev Support Team by submitting an IT Support Ticket, by phone at 1-(317)-794-3900, and/or by email at ask@gorev.com.

Note: If possible, always submit an IT Support Ticket detailing any problem that you are experiencing within GoRev. This will give GoRev Support Agents access to additional information that will help expedite the resolution of your issue. If you are unsure how to submit an IT Support Ticket in GoRev, please see theIT Support Ticket Creation for assistance.