The session status is what drives the revenue cycle management process. From the moment a session is added, the current status is being tracked. The status of a session allows you to perform different functions, such as creating an insurance invoice or billing a client. Each service line is capable of having its own status.
Note: When a session is automatically created using a Daily Note from WebPT, it is marked as confirmed.
Here is the general cycle (status) of a session:
On various screens throughout the app, the current status is listed for you. For example, navigate to Payments > Enter Payment > Single Session and look at the Status column. The status of the session will take on the following values.
- Unconfirmed: This status will typically only be used by Standalone/Non-integrated clinics. As previously mentioned, all sessions created by WebPT will be listed as Confirmed. To have an unconfirmed session, it will need to have been entered as a recurring session or have a Date of Service listed in the future. Unconfirmed means that the session has not yet happened. On or after the date of service of the session, you will want to confirm the session to let Therabill know that the session actually took place. Once the session has occurred, you will want to Confirm the session
- Confirmed: Once you have confirmed the session (and not yet billed it out to insurance), then the session will be listed as confirmed. This means that the session has happened and is waiting to be billed out to insurance. NOTE: A session can be listed confirmed after it has been billed to an insurance. This can be a result of needing to resubmit/correct a claim.
- Insurance Open: Once you have confirmed the session and create an insurance invoice, the session is now considered open to that insurance company. Therabill not only tracks that the session is open, it also tracks what insurance it was invoiced to. This allows for better payment entry and reporting.
- Closed/Patient Due: If a client is marked as Self Pay when a session is added (manually or from WebPT), it will be marked as closed. You can also mark a session as closed using a payment entry form. A closed session simply means that the session is closed to insurance and the patient now owes the remaining balance. A closed session does not mean that the balance due is equal to zero.
- Zero Balance: The balance due on the session is equal to zero. That is, the charge amount minus insurance payments applied minus client payments applied minus adjustments applied is equal to zero. A session can have a zero balance and be listed as open or closed. If the session is open, you may want to research why the session is waiting for an insurance payment when there is no longer a balance.
How do I select or change a Session Status?
There are several different ways to select or change a status.
- Add a Session (from WebPT) - When a session is created from a Daily Note in WebPT and the case has an insurance listed, the session will be marked as Confirmed. If the client is Self Pay, the session will be marked as Closed/Patient Due.
- Add a Session (directly in Therabill) - When manually adding a session, you will see the Initially bill to drop-down in the Billing & Coding section of the Add Session screen. You can either indicated Insurance, Client, or Agency.
- Entering a Payment - When you use a payment entry form (Single Session, COB Batch Ins, Batch Ins, or ERA) you are required to select an action for each service line that a payment or adjustment is being posted to.
What does each Session Action do?
When entering a payment, you have various Session Actions available. The name of the action will vary based on the payment entry form you are using and on the current status of the service line.
- Keep current session status - Choosing this action will keep what status is currently listed. For example, if a session is currently open to Medicare, the session will remain open to Medicare after the payment is posted. This is useful if you are creating a Corrected Claim for a Print & Mail insurance.
- Send to insurance invoice area/Resubmit - Choosing this action will change the status to Confirmed and place the service line back in Billing > Bill Insurance. This action is used if you need to resubmit a claim or send a new claim to a secondary insurance.
- Close Session/Bill to Client/Close Service-Patient Due/Bill remainder to client - Choosing one of these actions will result in the session being marked as due by the client. This would be selected when you are no longer waiting for an insurance payment and are needing to bill the remaining balance to the client.
- Bill to agency/Bill remainder to agency - Choosing this action will send the service line to Billing > Bill Agency. This is used if someone other than an insurance, client, or responsible party is liable for the balance (i.e. a school or lawyer's office).
- Mark as billed to/Crossover - Choosing this action will tell the system that the insurance claim was sent to another payer on your behalf. This will affect reporting and where the session appears on the insurance payment screens. Important: This does not create a claim and send it to that payer. This is to only be used to an EOB/ERA explicitly states that the claim was forwarded to an additional payer.
This is an example of the Single Session screen.
Why is the session closed? I never used a Close Session action.
There are 4 different ways that a session can become closed.
- Initially bill to - When you manually add a session, you are required to select an option from this drop-down menu. If you select Client, the session will be closed, because the client owes the balance.
- Payment Entry - When a payment is posted, a close action was selected.
- Session Class - If you assign a session class with Ins Not Billable as a feature, then the session will close. Note: Removing a session class will not alter the status.
- Accept Assignment - If Accept Assignment is marked as No on a client's insurance card, the session will close after the insurance invoice is created. This is extremely useful if a client would like to be reimbursed by their insurance, but are paying you as Self Pay.