The new billing periods in AlayaCare are based on a set frequency to prevent gaps between billing periods and allow recently approved items to be back billed automatically. The new billing module in the accounting suite also features a new invoicing engine that allows for billable items to split between multiple bill-to parties according to the rules set on a payor program, all-new master and individual invoice screens, and the ability to view information about errors during invoice generation background jobs so you can action them.
Setting up billing periods
To generate invoices, you will need to create a billing period for the frequency you wish to bill for by going to Accounting>Billing>Billing Period for Payor Program.
You will see all existing billing periods by frequency listed along with their billing frequency, branch (if applicable), start date, end date, duration, invoice date, number of draft invoices, number of sent invoices, and status of any background jobs listed here. Note that billing periods are created by branch and billing frequency. There can be no overlap between periods in terms of branch and frequency.
Select +create billing period.
In the dialogue, select the branch and billing frequency (1 week, 2 weeks, 4 weeks, or calendar month) and enter a start and end date along with an invoice date. The start date can only be set on the first period created for the billing frequency (of the same branch).
If a billing period already exists for the billing frequency selected, the start date will be set to the end date of the previous period plus one day.
When you have finished, click save.
Click the downward arrow next to view if you need to edit or delete the billing period or restrict new shifts.
Note that you can only edit the most recent billing period for the branch and frequency. You can modify the invoice date, end date, and start date (if it is the first billing period for the branch and frequency) as long as there are no invoices for the billing period yet. If invoices have already been generated for the billing period, you will not be able to edit it.
The status in the background job column refers to the status of invoice generation and regeneration processes. If a status of failed or partial success is displayed, you can click the icon to view more details.
The background job report dialogue will provide more information about the specific error that caused the job to fail.
Reviewing the invoice list
When you are ready to proceed with the invoicing process, click view to open the billing period. Note that if your organization uses a multi-office setup, the application will switch to the branch that owns the billing period and filter content accordingly.
Clicking view will open the visits tab within the billing period. From here, you can approve all visits and premiums included in the billing period and resolve any unscheduled visits as you would before generating invoices using the old billing methodology in AlayaCare.
When you have finished approving source items, click on the invoices tab and select generate invoices. This action will queue a background job to generate invoices for client programs that do not yet have a master invoice in the billing period.
Once you click to generate the invoices for the approved visits and premiums during the billing process, the system will check each billable item in a billing period to see if it is associated with a payor program. If the item is tied to a program, the system will check to see how the item should be billed according to the benefit rules set on the program. The rates applied to each item will be determined by the rating funder selected for the service or client billing premium.
If the service or premium uses the single payor billing methodology, a single invoice will be generated for the payor using the rate associated with the item's bill code.
If the status if the generation background job is partial success or failure, an info icon will appear next to the status. Click the icon to view the background job report and identify which programs caused errors during the invoice generation.
Once the generation background job has finished, the invoices list will display the invoice number and version, client name, payor, funder methodology (long-term care insurance, copayment, single payor, etc.), program name (applicable only for payor programs), master invoice ID (applicable only for payor programs), invoice status, current balance, and total amount billed for each individual invoice in the billing period.
The status of the master invoice depends on the status of all invoices for that client and program. If all the invoices have the same status (draft, deleted, sent, paid, written off, or void), then that will be the master invoice status displayed in the invoices list. If at least one of the invoices has a status of paid, written off, or copy, then the master invoice status is sent. Note that the master invoice cannot have a status of copy.
You can filter this list by invoice number, client name, invoice status, client group, program name, funder methodology, bill-to party, master invoice ID, and balance amount range. By default, the list will filter to all statuses other than void and deleted.
At the top of the list, you will see action buttons to export, delete, void, send, and regenerate invoices. Use these buttons to perform actions on all invoices in the master invoices list. When choosing one of these actions, any master invoices that the selected action cannot apply to will be filtered out (only invoices in draft status can be deleted, sent, or regenerated, and only sent invoices can be voided).
After clicking the action button, you will be able to select which invoices you wish to perform the action by checking the box next to the invoices you wish to include or clicking the box in the top left corner to select all. Click the blue action button action (export, regenerate, delete, send, etc.) to proceed.
To perform actions on a specific invoice, click the downward arrow next to view. For invoices with a status of draft, you have the option to send, delete, or regenerate. For invoices that have been sent, you have the option to void. None of these actions can be performed from this list on invoices with a status of deleted, paid, written off, void, or copy.
Keep in mind that clicking generate invoices again will create new invoices for any client programs or single payor services and billing premiums that do not have invoices in the billing period yet and new invoices for any newly approved items tied to payor programs or single payor services or client billing premiums that have sent invoices for that billing period. It will not modify any existing draft invoices. If you have newly approved source items that should be included on an existing draft invoice in the billing period, you should select regenerate rather than generate invoices.
Clicking regenerate will delete the invoices selected and re-run the background job to account for any changes to the source items. The version number of the invoice will be indicated in the invoice number for the individual draft invoices.
Reviewing the invoices
To review the individual invoices, click view invoice for the invoice you wish to review.
This will open a screen that displays the master invoice status, billing period summary, payor program summary, and invoice details for the guarantor and payor along with a list of all billable items included on the invoices.
Payor program example:
Single payor example:
Depending on the status of the invoice, different action buttons will be available (delete, send, and regenerate if draft and void if sent). Export will be available for invoices of all statuses. Note that if you use these buttons, the actions will be performed on the invoices for both the payor and the guarantor (in other words, you cannot delete/regenerate/send/export a single invoice from these buttons).
In the invoice details section, you will see invoice details listed for all invoices generated (one or more depending on whether you are using single payor or payor programs). The invoice number and payor/guarantor name, invoice amount, amount due along with any payments and adjustments for the payor/guarantor will be listed. If the invoices have been regenerated to account for any changes to the source items, the version number will be indicated in the invoice numbers (53 v.0, 53 v.1, etc.).
To download an individual invoice, click the export button. In the dialogue box, AC standard invoice will be selected as the invoice export type and PDF as the format. If you are using the two-page invoice, you will also be able to select the AC standard invoice with summary page. When ready, click export.
Adding a miscellaneous charge
For invoices in draft status, you will also be able to add miscellaneous charges to individual invoices from the invoice details section. To add a charge, click the add misc. charge button.
For single payor invoices, the button will appear at the top of the screen:
In the add misc. charge dialogue, enter a description of the charge being added. This description will appear on the invoice.
Select a reference date, GL revenue account, and if applicable, a cost centre. The reference date will be the date shown for the charge on the invoice. Note that only dates within the current billing period can be select. The cost centre field will only be displayed if cost centres are configured for your organization.
Enter the quantity and rate of the charge. The quantity must be above 0 and can contain up to 2 decimals. Once entered, the sub-total (excluding taxes) will appear below.
Finally, select one or more tax that should apply on the charge if necessary. The taxes available to select will correspond to the taxes available in the branch that the payor program belongs to. The total taxes and total amount of the charge (including taxes) will appear in the corresponding fields.
When you have finished, click save. The charge will be added to a miscellaneous charges list in the invoice billable items section.
In the invoice billable items section, the billable items will be divided into billed items and split billed items depending on whether the item is covered by a single bill-to party or divided among multiple bill-to parties.
The type, reference ID, service date, scheduled time, employee, quantity, rate, service description, payor(s), amount, and total cost charged will be listed for each item. You will also be able to click on a hyperlink for the billable item in the ref ID field to view more details about the visit or premium.
If you wish to edit how much of the item’s total cost will be paid by the payor versus the guarantor, click the edit button next to the billable item.
For split billed items, you can then adjust the amount paid by the guarantor and payor(s) in the amount column. When redistributing the total, the sum of the amounts of the new distribution must equal the total value of the billable item.
For billed items like premiums that are not split, you can select whether the guarantor or payor should cover the total cost of the item using a dropdown in the payor field.
If any additional charges have been added to the invoices, the invoice billable items section will also contain a miscellaneous charges list.
The type, invoice # and payor (the funder name), description, ref ID (if applicable), reference date, employee (if applicable), quantity, rate, amount, taxes, and total will be listed for each charge. The type will be manual if the charge was created on an invoice and automatic if it was added to an invoice during the invoice generation process. Note that the ref ID field will only be filled out for charges of type automatic. As with other billable items, it will contain a hyperlink that opens the visit, visit premium, or client billing premium. The employee field will be filled out if the charge is a visit or visit premium. Select edit to make changes to the charge.
When you are ready to mark the invoices as sent, click send.
In the dialogue box, click Send to confirm.
Once the invoices have been sent, you can add transactions to the individual invoices as necessary. Click the +Add Transaction button on the invoice.
Note that you must be in a role that has the Manage Transactions ACL to view this button.