Billing - Need Invoice and Electronic Claim Generation
Answered
We have a few patients where there are two payors, one takes a paper invoice (BCBS - Primary Payor) and the other takes an electronic claim (Medicaid - Secondary Payor). We typically enter these patients as an electronic funder type under Medicaid for ease of submitting the secondary claim electronically when the time comes. Are we able to generate a paper invoice (AC Standard Invoice, for example) on these patients when their payor methodology is entered as electronic? If not, this would be very helpful for these situations. Right now, we are hand-typing out a paper invoice outside of AlayaCare to send to the primary payor.
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Official comment
Hi Emily,
I spoke with the product team and they let me know they are aware of this use case and unfortunately, AlayaCare doesn't currently support:
- Coordination of benefits (multi-payor billing) for electronic billing claims.
- Paper claims for the either professional (SCM 1500) or institutional (UB 04) billing.
Neither of these features are currently on the roadmap but they are both on the team's radar for the future.I hope that answers your question.AlexComment actions -
Hi Alex, I'd like to revisit this one if I can, because I think my original ask may not have been communicated well. We do not need to print a CMS1500 or UB04 on an patient with an electronic funder source. Waystar can do that for us. What we need is the ability to print a generic AlayaCare standard invoice on a patient with an electronic funder. The use-case is as follows:
- 5 or 6 of my patients are funded by BCBS primary (paper invoice for billing) and Medicaid (electronic funder) for secondary. AlayaCare can't handle this billing scenario currently, so we have to pick one or the other funder type to put in AlayaCare, and are left manually generating the other claims/invoices as needed. We enter all these as Medicaid / electronic so that when the time comes to submit the more complicated secondary claim to Medicaid, we can do that electronically. Because of this, we now have to manually type up a generic paper invoice to send along to the primary payor, BCBS, and we are making mistakes on them. We copy / paste the AlayaCare standard invoice, have it in excel, and are manually editing this format as needed to send out our BCBS claims, but it is time consuming and causing errors in billing.
My ask would be that we are given the ability to print a generic invoice (not a paper claim, just a generic AlayaCare invoice) on any patient, regardless of their funder type being electronic or not.
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Hi Emily Wiechmann,
I passed your additional context along to the product team. They looked into it and unfortunately, this is not possible given the way that the system is currently configured. However, they understand the reasoning behind this request and it's something they will investigate in future planning sessions. Sorry I don't have better news for you right now!
Alex
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