TARRY HOUSE, INC.

 

Subject:  Billing Procedure

 

Procedure Number:  B.P. 16

Site: All Appropriate Sites

Approved: 2/23/09

Issued By: Executive Director

Effective: 2/23/09

Approved By: The Board of Trustees

Revised:

Reference Policy: BP 01

Reviewed:

 

Standards Reference:

CARF: Section 1. F.

ODMH: 5122-30

 

I.                   Purpose

 

To maintain acceptable billing practices.           

 

II.                Procedure

 

It is the responsibility of the Executive Director to ensure Tarry House staff members are adequately trained and complete the organization’s billing procedure as part of every day business as follows:

 

A.     The Tarry House Recovery Home’s Recovery Specialist and the Tarry House Respite’s Secretary/recovery aide (or designee) will complete the New Member Enrollment/UCI Request (MACSIS) Form for all new admissions.  The original form will be forwarded to Staff Secretary within 5 business days.

B.     Staff Secretary will review forms to ensure all required fields are complete and legible and fax to the ADM Board.  If a person’s enrollment form was faxed to ADM within 90 days prior to the current date, the updated form does not need to be submitted.

C.     ADM Board will then provide a MACSIS No. for each new admission and return (via fax) to Staff Secretary. 

D.     Staff Secretary to input information from MACSIS Forms into electronic database – EZClaim.

E.      Program Managers to forward census sheets to Staff Secretary and a copy to the Bookkeeper on a weekly basis.

A.     Key: B=Bed Day; T= therapeutic Leave Day; H = Hospital Day; A = AWON Day

B.     A “bed day” is recorded for anyone in the home over night - census should be completed in the morning.

F.      Staff Secretary will utilize the census information and electronically bill the ADM Board on a weekly basis, not to exceed two weeks.

G.     Staff Secretary to print hard copy of billing information (Exported Claims Report) and give to Bookkeeper.  Both the Staff Secretary and Bookkeeper review census sheet and compare to Exported Claims Report to ensure no errors occurred.  If error is detected, follow up with phone call to the ADM Board and follow their direction to make correction.  

H.     When payment is received, the Bookkeeper to utilize Exported Claims Reports to ensure the amount paid to Tarry House matches the billing.  If an error is detected, follow up with phone call to the ADM Board and follow their direction to make correction.  

I.        Quarterly, the Executive Director or designee will complete a random sampling of past billing for quality control purposes.  This audit will include reviewing a sampling of clinical records and look at dates of admission and discharge (if person has been discharged), look at progress notes to ensure person was served that day (bed day versus therapeutic leave or hospital day) and then cross  referencing this information with the census sheets and the Exported Claims Report. 

 

 

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Executive Director                                                                                                        Date