Many insurers will reject claims when more than one billing code is listed on a single line on a submitted invoice/superbill. This article goes over how to breakdown charges in your charge list that have multiple billing codes, and set it so that each component billing code is listed on a separate line item when you generate an insurance invoice or superbill, minimizing the risk of the invoice being rejected.
- Add to or Edit Charge List
- Generate an Invoice or Receipt
- Generating an Insurance Invoice for Visit Charges Covered by a Recurring Subscription
For a charge in your charge list that has multiple billing codes, you can manually set each component billing code to display as a separate line item when you generate an insurance invoice or superbill. This may be needed because many insurers will reject claims when more than one code is listed on a single line on the submitted invoice.
To set this up, you would click on an existing entry in your Charge List to open it for editing, then click on the button near the bottom that says "Manage how this charge displays on an invoice" :
Enter the code breakdown as you would like it to appear on the invoice, then click SAVE CHANGES to save. Any invoices generated with this charge on them in the future will show your specified breakdown.
For example, let's say that you offer a new patient visit, which takes 120 minutes, for $600. You code based on time, and the billing codes for that visit are:
- 123 - Initial visit, 60 min in person
- 456 - Additional time
In the Charge List entry for this charge, you would put the multiple codes in the code field, separated by commas. Then, if you want to set it up so that each code was displayed as its own line item when this charge appeared on an insurance invoice or superbill, you would click the link near the bottom of the Add/Edit Charge window that says "Manage how this charge displays on an invoice", adding a line-item for each code as shown:
For practices that have different Plan A/B pricing, the breakdown should be based on the Plan B (non-discounted) rate. When it is used for a Plan A patient, the system will apply a discount proportionally to each line item.
Similarly, if you apply a discount to a charge that has a line-item breakdown defined, the system will apply the discount proportionally across the line items on an invoice.
This article was originally published on April 5th, 2017, and was most recently updated on August 25th, 2021.