Setting the Billing Fields

AngelTrack collects some billing information during call-taking. This information is very important, because it is later used to automate many aspects of the billing process.

The Fields Explained

Every dispatch has the following panel of billing fields, freely editable by any dispatcher or biller at any time:

Payment options

☑ Billable

The ☑ Billable checkbox, when unchecked, causes the dispatch to skip over all of the billing steps of postprocess, going straight from  Awaiting QA review  to  Finished . There will be no attempt whatsoever to collect payment.

The reason it is a separate checkbox is so that it can be checked and unchecked as needed, without perturbing the rest of the dispatch's billing settings.

You may choose to uncheck the box in these sorts of situations:

As already mentioned, you can always re-check the checkbox later if you change your mind.

Unlike all other billing fields, ☑ Billable is not carried forward into recurrences. The checkbox must be manually un-checked each time the dispatch recurs

☑ Bill insurance

Attempt to bill the patient's insurance for the service. The call will be reviewed first (in the Insurance Review Queue) before a claim is filed.

If you would like AngelTrack to automatically tick or automatically untick this checkbox, visit the Preferences page under Settings (you will need Administrator access to do so), find the "Billing" section, and change the insurance defaults for the various services you offer.

If ☑ Bill insurance is unchecked for a call that would normally be insurable, then AngelTrack will prompt the crew on-scene to collect a signature on the A.B.N./N.C.D. form.

☑ Bill facility

Bill the facility for services, at the facility's contract rate (if any) and/or the retail rate. The dropdown list of billable facilities includes:

☑ Bill affiliate

Bill the affiliate for services, at the retail rate. Check this box when an affiliate rolls you a call that they obligated to you to pay.

The dropdown list of billable affiliates is built from the Affiliate List. It includes all affiliate records which are flagged ☑ Billable.

☑ Bill patient

Bill the patient for services. This option is automatically assumed, even if unchecked, if the other three bill-to options are all unchecked.

If also billing insurance, then the patient's insurance provider will set the allowed price, for which the patient is ultimately responsible. If the patient has no insurance coverage, then AngelTrack will apply the patient's price schema (usually retail) applies instead.

☑ Cash up front

Check this box when the fee for service should be collected directly from the patient by the crew while on-scene.

When that box is checked, AngelTrack requires a price quote. The Dispatch Create page will calculate it for you, based on the anticipated transport mileage.

Once the call is active, AngelTrack will prompt the crew on-scene (and again at destination) to collect that sum of money.

Price Quote

The price for a service can be quoted up front, during call-taking. AngelTrack provides some assistance there, displaying a live map showing the proposed route, the mileage, and the calculated price. You can go with the calculation or calculate it yourself. The official price then goes into the "Price quote" textbox on the Dispatch Create or Dispatch Edit page.

All of that can be done up front, if you wish. The quoted price will then be honored by AngelTrack throughout postprocess (although insurance may push back a lower "allowed price"). You can do this for any dispatch regardless of other billing and service settings.

AngelTrack was built on the assumption that price quoting does not happen until postprocess, after QA is done and mileages checked. Only then do you know for certain what services were actually delivered. It is normal and even expected for there to be no price quote during call-taking.

Automatic Setting During Call-Taking

While booking a new dispatch, AngelTrack automatically sets the billing fields as best it can. In doing so, it takes account of the following:

Naturally, the dispatcher can override the automatic settings at any time.

If AngelTrack fails to automatically select ☑ Bill facility when you think it should've, then check the facility records to make sure your contract with the facility is recorded.

Eligibility Check via NSure

AngelTrack can check perform a live eligibility check against the patient's insurance policy, if the patient's primary policy is on-file. This feature requires AngelTrack's NSure integration to be active. When those requirements are met, AngelTrack lights up the NSure icon NSure next to the icon Expand that opens the popup patient editor:

Patient data popup

If you open the popup patient editor, you can run queries for demographics and insurance discovery, provided your NSure account is configured with those products.

Prior Auth Requirements

AngelTrack indicates a recommendation on the need for a PAN and/or PCS based on the circumstances of the call and the insurance on file for the patient.

If the patient's insurance is unknown, then AngelTrack will conservatively assume it is Medicaid+Medicare. In that case the patient will require both a PCS and a PAN -- provided, of course, that the call is insurable and not emergent.

You can check to see what insurance the patient has on file, just mouse over the patient's name:

Patient data popup

Remember that patient records can be individually flagged as ☑ Always needs prior auth or ☑ Never needs prior auth. These flags will affect AngelTrack's recommendation about PAN requirements.

Discounted Rates for Certain Self-Pay Patients

If you have specific self-pay patients who have arranged to pay less than retail, you can check or change their rate during call-taking.

The patient must have a patient record in AngelTrack, so if the patient doesn't have one yet, create it by pressing the "Create a Record Now" button. Once the patient's record is attached, you can open the popup patient editor by clicking the Expand button. The patient's price schedule is set to retail by default, but you can change it here and then save.

Your administrator must configure the below-retail Patient Rates, using the Pricing page under Billing home. There is no limit to the number of different patient rates which can be configured. Once that's done, dispatchers can assign the rates to specific patients.

Once you assign a discounted rate to the patient's record, the patient's price will be displayed along with the retail price. (If any contracted facility records are attached, the contract price is shown too.)

Promising a price in advance

While you are booking the call, you can give a specific price in advance, or else you can give a specific rate to be applied to whatever mileage actually incurs.

If you give a specific price, record the promised price in the dispatch record's "Price quote" field. That price will then be honored throughout the billing process, even if the mileage runs longer than expected.

If, on the other hand, you give a specific rate, then do not fill in a price quote; just leave it blank. AngelTrack uses "lazy price quoting", so the dispatch will eventually be priced once it passes QA and the final mileage and runtime are determined. AngelTrack's invoice generator will then apply the patient's promised rate. To learn more about how pricing works, read the Pricing guide.

Invoicing a patient at the facility's contract price

Some facility contracts specify that resident patients are permitted to book private self-pay calls at the same rate the facility pays for official business.

As usual, you can handle it as a promised price, or as a promised rate to be applied to whatever mileage eventually incurs. To promise it up-front, let the Dispatch Create page calculate the mileage and display a contract price, then simply type the contract price into the "Price Quote" field. Otherwise, leave the dispatch unquoted, and the facility's prices will be applied during invoicing.

Patients Under a Hospice Contract

When booking a call for a patient covered by a hospice contract, you must select the hospice agency as the bill-to facility.

The choices in the bill-to facility list are constructed like this:

Therefore, if you do not see the hospice agency in the list of bill-to facilities, then you must edit the patient's record and set their residence facility. You can do that right in the Dispatch Create page by clicking the Expand button to open the patient data popup editor.

If the patient is new and so does not yet have a patient record, you can create one on-the-spot by clicking the "Create a Record Now" button... and then open the patient data popup editor.

To learn more about automating the billing of hospice contracts, see the Hospice Contracts section of the Patient Residence guide.

Editing the Billing Fields Later

At any point in time, during or after call completion, a dispatcher or biller can modify the billing fields.

Modifications to the billing fields can cause a dispatch to move horizontally or vertically in the postprocess workflow. For example, if you uncheck ☑ Bill insurance from a closed dispatch sitting in the Insurance Review Queue, then the dispatch will immediately exit that queue and move to a different queue -- perhaps the Invoice Generator for Facilities, waiting to be invoiced to the facility.

Another example: if a dispatch is waiting in the Invoice Generator for Facilities, and you uncheck uncheck ☑ Bill facility and then check ☑ Bill patient, the dispatch will immediately move to the Invoice Generator for Patients.

Edits to ☑ Billable

Remember that edits to the ☑ Billable checkbox are not carried forward into future recurrences of the dispatch. The checkbox will always be re-checked in the recurrence, so that you do not have to remember to re-check it if you have un-checked it.

This protection means that AngelTrack does not support recurring non-billable calls, unless they are of a specific service level, and you configure that service level as non-billable.

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