RMS has many options for configuring billing models per facility. This example is a standard billing model with a single daily rate for Part A and like payor sources. Part B and like payor sources are billed as a percentage of the physician fee schedule. For Part B you can also set the percentage of the MPPR burden that will be paid by the facility vs the therapy provider.
Standard Model % of Daily Rate
This is an example of the standard model but Part A is configured as a percentage of therapy rate as calculated using facility wage index and patient case mix.
Other billing models include By Hour and By Encounter. This is an example of By Hour. Simply set a rate by therapist and assistance by discipline.
By Hour Sample Billing
Sample billing if ‘By Hour’ model is configured.
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The system will generate Therapy statement with each payor source broken out as separate line items. There are numerous billing models that can be selected.
Part A Summary Flat Rate
Part A summary page provides each patient and how many billable patient days for the month. This example is using a single per diem rate.
Part A Summary % of Therapy Daily Rate
This example of a Part A summary page utilizes a percentage of the therapy component daily rate. Each patient’s billable days is broken out by the number of days at each rate that is applicable.
Part A Resident Billing Log
A detailed billing log is provided for each patient regardless of payor source. This example is of a Part A patient. The assessment data and case mixes are provided as well as all necessary modifiers.
Part B Resident Billing Log
This is an example of a Part B billing log. Patient’s units and totals are broken out by discipline. All necessary modifiers are provided for billing.
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Part A Billing Export
Generate billing data tailored to your billing system’s requirements and export for uploading. If we do not offer an export in your required layout, one can be customized. A few of the EMR/billings systems that we can provide billing exports for are Point Click Care, American Health Tech, BlueStep, HealthMedx, MatrixCare and others.