Auto Charge Generation

Auto Charge Generation allows you to create or update multiple charges at once based on defined criteria (e.g. generating Room & Board charges or to accommodate Medicaid billing requirements). It evaluates the patient's primary (Sequence 1) insurance unless Primary Insurance Only is unchecked or Selection Type is set to Insurance. Patient admit and discharge dates are taken into consideration so charges are not created outside of an admission period.

Tip: For recurring processes, create a Report Group (File > Report Groups) so your selections are saved for next time.

Go to Charge > Auto Charge Generation

Auto Generation Type

Choose the action you want to perform.

Charge Create: Creates charges using a selected charge code (e.g. Indiana Medicaid Overhead Rate). Review Indiana Medicaid FAQ for more details.

Institution Stay: Creates Room & Board charges based on the patient's assigned Institution. Requires Institute setup with a "Bill-To Charge" in File Maintenance > Entity.

Charge Split: Splits one charge into two (e.g., different rates or HCPCS for portions of a visit). Use the Charge Split tab for additional setup.

Charge Replace: Replaces one charge code with another in bulk. Use the Charge-Replace tab for additional setup. Note: may not be used for charges imported from Clinical software.

Selection Type

Defines which records to include. Options vary based on Auto Generation Type chosen. Choosing anything other than All Records limits the selection. Use the Specific Includes tab for additional setup.

Patients: Filter for specific patients. Alternatively, use the "Exclude" option on the Specific Includes tab to exclude selected patients.

Insurances: Filter for specific insurances. Un-check the Primary Ins Only box if you want to generate charges for all patients with that payer, regardless of it's sequence (e.g. primary, secondary, etc.). Alternatively, use the "Exclude" option on the Specific Includes tab to exclude selected insurances.

Units: Filter for specific Units. Alternatively, use the "Exclude" option on the Specific Includes tab to exclude selected Units.

Ins-Classes: Filter for specific Financial Classes. Alternatively, use the "Exclude" option on the Specific Includes tab to exclude selected classes. The Financial Class must be the patient's primary (Sequence 1) insurance to be included.

Charge Detail

Available for Charge Create, or Institution Stay.

One Per Day: creates one charge for each day in the range.

One Per Patient: creates one charge record with Quantity equal to total days in the range. The charge date will be the To Date used.

One Per Period: creates one charge record with Quantity equal to 1. The charge date will be the To Date used. Utilized for Palliative Care Case Management (Note: if the payer doesn't allow a charge for patients admitted on the last day of the month, exclude the last day of the month from the specified date range.

Primary Ins Only: When checked, only patients whose selected insurance is the primary (Sequence 1) are included. Uncheck to include all patients with the specified insurance regardless of payer sequence. For Charge Create and Institution Stay when Selection Type is set to Insurance, charges are created for all dates in the selected range if the insurance is active for the patient on any date within that range.

Preview Charges: Displays expected results before generating charges (recommended).

Include Discharge Day: (Institution Stay only) When checked, a charge is created for the patient's discharge date (if within the selected date range). Uncheck if the payer does not reimburse for the discharge date.

Include Death Date: (Institution Stay only) When checked, a charge is created for the patient's date of death (if within selected date range). Uncheck if the payer does not reimburse for the date of death.

Data Applicable to Each Charge Generated

Set values to apply to all generated charges. Available for Charge Create and Institution Stay types.

Charge: Specify the charge code to be used for Charge Create routine.

Employee: Specify the employee to associate to the charges.

Pay Rate: Specify the employee pay rate for the charge if using payroll reports or exports. (Optional)

Time: Enter the visit time or default to zero.

Batch: Enter the batch number to be assigned or defaults to zero. Charge Split only uses this number if one isn't found for the charge being split. (Optional)

Print button: Access the Charge Detail List Report to view charges created via the Auto Charge Generation routines.

Charge Split Tab

Used when part of a visit is billed differently or to split charges spanning midnight.

Specify the Charge to Split and the Charge to Receive Split as well as the Time threshold. Any remaining visit time beyond the Time specified will be billed under the Charge To Receive Split code. Charges must have start/end times and be assigned the same Care Type.

To split charges spanning midnight (i.e. for Colorado PDN), enter the same code in the Charge-To-Be-Split and Charge-To-Receive-Split fields and set Time to '0.' Use More Options tab for additional requirements.

For Colorado Medicaid CNA and CNA Extended charges, enter Time as 1 and utilize the More Options tab for additional requirements.

Charge Replace Tab

Used for changing incorrect charge codes or to change them based on other reasons as specified on More Options tab.

Specify the Charge To Be Replaced and the Replacement Charge. For MassHealth billing, utilize the More Options tab for additional filtering.

More Options Tab

Allows additional specificity for Charge Create, Charge Split or Charge Replace routines.

Charge Create Options

Add Charge for Each Day That a Billable Visit is Found: Used for creating Indiana Medicaid Overhead rate charges.

Only 1 per Household: Evaluates Address 1, Address 2 and City fields across patients to identify the same address and only creates one Overhead charge per day per household. Used for Indiana Medicaid Overhead rates.

Create Charge as Held: the Held mark will be checked when the charge is created so it's not billed until ready.

Institution Stay (Room and Board) Options

Fix Charge Override Rates when Charges were Created with Incorrect Rates: updates the Charge Price Override amount for Institution Stay Room & Board charge creation.

Charge Split Options

Round Split Time Up to Nearest 1/4 Hour: rounds remaining time to nearest 15 minutes.(e.g. an additional 16 minutes rounds to 30).

Only Split Charge If Time Greater Than: split only if time exceeds a specific threshold. CO Medicaid Home Health CNA and CNA Extended charges requires at least 15 minutes over the first hour elapses before an extended unit/charge can be billed. The first hour of service is billed under the original charge code and additional time over 15 minutes is billed under the Split To charge.

Only Split Charges that Cross Over Time: split visits that cross over a specific time. Defaults to Midnight for CO Medicaid PDN visits spanning midnight. A different time can be specified for payers paying different rates based on time of visit.

Charge Replace Options

Only Non-Institutionalied Patients with/LOS Days Greater of Equal to: Accommodates MassHealth requirement to bill a different revenue code when a patient's LOS is over a specified number of days.

Only Replace Charges with Time Less Than or Equal to: Enter number hours in the box. Assists with FL PPEC billing requirement that visits 4 hours and under bill with different claim codes.