Facility/Unit Billing Matrix
The Facility Billing Matrix is designed to store all of the payors, price codes, charge accounts, and exclusions. This matrix interacts with the Patient Billing Matrix. The purpose is to allow price codes and charge accounts to be assigned automatically, based on the Facility, as pharmacy staff fills drug orders. This alleviates the need for pharmacists and technicians to be involved in choosing the correct Price Plan or change account. QS/1 recommends that pharmacy billing personnel set up and maintain the Facility/Billing Matrix.
Patient Billing Matrix
The Patient Billing Matrix is designed to establish payor status specific to each patient. The Patient Billing Matrix is enhanced to track multiple pay status changes and concurrent coverage. The Patient Billing Matrix interacts with the Facility/Unit Billing Matrix to determine the correct Price Plan and charge account.
When
filling new orders, if the patient has an active entry in the Patient
Billing Matrix, the Primary Payor displays on Step 1 of the order filling
process. These orders show 'Payor' instead of 'Payment' for the field
name in which the payor displays. The second and third payor fields remain
blank.
Initial Setup
The following files must be set up for the Billing Matrices to work properly:
What would you like to do?
Set up Security Access for Billing Matrix
Set up Drug Categories for Billing Matrix
Set up the Facility/Unit Billing Matrix
Set up the Patient Billing Matrix
Change a Payor on the Billing Matrix