MEDICAID BILLING

Keep Current through Every Medicaid Billing Change

Simplify your Medicaid billing and accounting, and get support whenever you need it.

MEDICAID BILLING

Keep Current through Every Medicaid Billing Change

Simplify your Medicaid billing and accounting, and get support whenever you need it.

HIPAA

Available stand-alone or integrated with Fund EZ Accounting, our Medicaid electronic billing system can be used to bill Medicaid patients.

Full Support

Get full support for all Medicaid billing, including 837I and 837P transaction codes, 999 response files, and 835 electronic remittances.

Simplified Accounting

Integrate with Fund EZ Accounting to simplify accounting transactions for billing, payments and adjustments, and automate void creations.

HIPAA

Available stand-alone or integrated with Fund EZ, our HIPAA electronic billing system can be used to bill Medicaid patients.

Full Support

Get full support for all Medicaid billing, including 837I and 837P transaction codes, 999 response files, and 835 electronic remittances.

Simplified Accounting

Integrate with Fund EZ to simplify accounting transactions for billing, payments and adjustments, and automate void creations.

See how easy Fund EZ can be.

Let’s talk about how Fund EZ can help your nonprofit save time, reduce risk, and put more money back into your projects.

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MEDICAID BILLING

Fund EZ is an electronic billing system that’s HIPAA compliant and can be used to bill Medicaid throughout the United States.

Medicaid Defined

Medicaid is health insurance for underprivileged people who can’t afford insurance for some or all of their medical bills.

Medicaid does not pay money to individuals. Instead, it sends payments directly to health care providers. Eligible recipients are sometimes asked to make a small co-pay.

Medicaid has grown very rapidly over the years, primarily due to:

  • New laws to cover more people.
  • Population growth, and economic recessions.
  • Expanded coverage and more utilization of services.
  • Increases in the aging population.
  • Rising drug costs and the availability of new drugs.
  • Increased rates to providers that have been out-pacing inflation.

ELECTRONIC BILLING

Fund EZ Medicaid Billing:

Creates native HIPAA compliant billing files – it does not simply translate non-HIPAA files like other less sophisticated programs.

Supports 837I and 837P transaction code sets.

  • Reads and acts on 999 response files downloaded from payers that confirm the state of a recent billing.
  • Supports 835 electronic remittances and acts on those files to create cash receipts, setup rebills, and update claim history notations.
  • Supports manual remittance processing where 835’s are not available.
  • Fully integrated to Fund EZ’s general ledger and accounts receivable module.
  • Accounting transactions for billings, payments, adjustments by payer, adjustments by client, and voids are properly created automatically behind the scenes.

HOW IT WORKS

Billing Cycle – Fund EZ Medicaid Billing

1. Enter your billing claims with one of the following options:

  • Add claims manually.
  • Import claims.
  • Add via a quick click-thru calendar interface.
  • Add using a batch process called add from billing groups.

2. Create and submit the Medicaid billing file.

3. Download a 999 confirmation file.

  • 999 may confirm that the billing is good and accepted.
  • 999 may show that billing was rejected and show you the invalid claim, automatically setup your rebill claims, and conveniently bypass the entire remittance process.

4. Download an 835 electronic remittance advice.

  • Fund EZ reads the remittance and creates cash receipts for paid items.
  • Writes off A/R open bills with paid items.
  • Adjusts open A/R bills with credit/debit memos for prior period adjustments.
  • Sets up rebills for denied items and posts reasons for the denial (Rebills can be fixed by the user prior to resubmission).

5. Create new Medicaid billing file for new bills and rebills to begin the cycle again.

Claim Types and Statuses

Fund EZ claims undergo ‘type’ and ‘status’ changes as they flow through the billing cycle. The following table depicts possible claim states as they flow back and forth through the HIPAA cycle:

Type Status
Original Unbilled
Original Submitted
Original Paid
Original Denied
Rebill Submitted
Rebill Denied
Rebill Paid
Void Unbilled
Void Submitted
Void Denied
Void Paid
Adjustment Unbilled
Adjustment Submitted
Adjustment Denied
Adjustment Paid

*Fund EZ maintains a detailed claim history on every single claim that flows through Fund EZ Medicaid billing. In addition to the type and status field, the claim history will show details relating to the date, time, code and user that was involved in the creation, submission, denial, resubmission, and payment of the claim.

HOW TO BUY

Fund EZ product specialists are trained to assess your non-profits’ specific needs. You will receive a customized quote/invoice based on your organization’s needs.

  • Help determine products/modules required.
  • Determine concurrent user licenses and databases needed.
  • Explore web-based training classes and/or onsite consulting.
  • Explain different implementation options.
  • Assist with coordinating steps from purchase to implementation.

CALL US TOLL FREE AT 1-877-696-0900 (SALES)

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