Intellectual and Developmental Disability Providers Use EHR Software to Submit Medicaid Billing Claims Directly to Pennsylvania's PROMISe
HARRISBURG, Pa., Nov. 12, 2019 /PRNewswire/ -- Therap's billing system includes features for Pennsylvania providers supporting people with Intellectual and Developmental Disabilities (I/DD), enabling them to bill for both Community Participation Services (CPS) and residential services directly from documentation collected at the point-of-service. Therap's billing features apply CPS billing calculations of community-based services and calculate the percentages and service ratios for hours provided to individuals.
Therap's electronic billing sweep captures approved billing data so that Medicaid-funded providers may process Community Participation Services and residential services claims seamlessly through PROMISe. The system's flexibility allows claims to be created for an individual or as a group, and a billing department can send claims on one or multiple service lines to further tailor their billing process. Therap's reporting and audit tools aid agencies by identifying utilization, billing amounts, remaining service hours and dollars unaccounted, all to prevent overbilling, achieve maximum utilization, and prevent liability or recoupments coming from an inaccurate or duplicate payment for services.
Therap providers across Pennsylvania streamline their billing process by directly billing to the state's PROMISe system. Covered services by the Pennsylvania Department of Human Services, Intellectual Disabilities Services Division are tracked through the documentation, billing and claims process. Claims are automatically exported and formatted to ANSI X12 837 for upload. Billing and audit features are integrated with data collected by support professionals including service documentation and attendance, providing service verification and maximizing service hour utilization. A provider's billing data can be generated from multiple sources within Therap including case notes, attendance, service delivery, electronic visit verification/EVV, or manually entered as billable units. Reports follow the service and claim through all steps including billable/available units, submitted claims, and paid/rejected/denied claims. Therap can generate codes for each service line that link to external accounting systems and ledgers where needed.
Therap Services provides secure, web-based documentation, communication and electronic billing services to intellectual and developmental disability providers across the country. Therap's solution is used in HCBS Waiver, ICF/IID, LTSS, and other services to document residential and community-based supports, employment supports, electronic billing claim submissions directly to Medicaid.