Update to Medicare Take-Home Billing Requirements

Overview

You can now choose to have your clinic’s take-home and dispensing bundles billed on separate weeks. This change ensures that your clinic is adhering to current Medicare billing guidelines.

Configuration

Configuration requires enabling settings on the Carrier Bundle Service Billing and the Bundle Service Configuration screens.

Carrier Bundle Service Billing screen

1. Select a carrier using the Carrier dropdown and then select Edit Carrier Detail.

2. On the Insurance Carrier Information Management screen, select Modify Bundle Service Details.

3. On the Bundle Service Configuration screen, click on the desired take-home billable service under Billable Services and then select Edit.

4. Select the Do not bill take home units in the same week as dispensing bundle checkbox.

5. Select Save.

Note: This setting is only available when the saved Service Type is Take home Dose, or if the Service Type is calculated by selected services in billing combinations.

Bundle Service Configuration screen

1. Open the Accounts module and select Third Party Billing.

2. Select a carrier using the Carrier dropdown and then select Edit Carrier Detail.

3. On the Insurance Carrier Information Management screen, select Modify Bundle Service Details.

4. On the Bundle Service Configuration screen, click on the desired take-home billing combination under Billing Combinations, and then select Edit.

5. On the Edit Bundle Details screen, select the desired service from the Included Services. The service’s details appear under the Medication Administration section of the screen.

6. Under Units, select Takehomes per unit and add the following values for each field:

   1. Minimum: 1

   2. Maximum: 7

   3. Max Units: 3

   4. Per billing frequency: Monthly

7. Select Save Service Detail.