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Review billing details for a patient-day

Use Billing details to review the current service items and reimbursement calculations for a patient's day of service. It helps you see how same-day services are grouped before or after you review a facility invoice.

Before you start​

You need admin access and a service document with billing details available. Billing details is available from evaluations, treatments, and re-evaluations that include a service log.

Understand billing details​

Although this guide refers to a "patient-day," that is a simplification. A billing-details record is technically specific to a facility, patient, payor, and date. A patient is unlikely to have multiple facilities or payors on the same day, but it can happen. For example, payor A might cover PT and OT while payor B covers SLP. In that case, the patient has separate billing details for each payor on the same date.

Billing details combines every source service item in that group, even when the items come from different service documents. Reimbursement can therefore account for the day's services together, rather than calculating each document independently.

Open billing details​

  1. Open the patient's admission, therapy case, and service document.
  2. Find the Services or interventions provided today section.
  3. Select Billing details.

The button is shown only when the document has billing-details identity information and you have admin access. Select the close button in the upper-right corner to return to the service document.

Review billing details​

Check the summary​

At the top of the dialog, review the Facility, Patient, Payor, and Service date. These values identify the service-item group shown in the dialog. The dialog also shows the calculated Payor reimbursement and, when a facility contract applies, Facility reimbursement. Select a linked facility, patient, or payor name to open its record.

Check service items​

Open Service items to see every source service item in the group—not only the items in the document you opened. For each item, the table shows:

  • Service location and place of service (POS)
  • Discipline
  • Source clinical document
  • Therapist
  • CPT code
  • Minutes

Select a clinical document, service location, or therapist in the table to open its record.

Check payor reimbursement​

Open the Payor reimbursement tab to review the payment model, the reimbursement arrangement, and the billing provider or providers represented by the service items. It also shows the calculation details and total payor reimbursement.

When unit allocation is available, the Service-item units table identifies full and partial units, CPT code, discipline, minutes, licensure level, billing provider, service location, modifiers, multiple procedure payment reduction (MPPR), and payor reimbursement. An asterisk beside a unit number means the document you opened contributed minutes to that unit.

For Medicare Part B MPFS calculations, the table also includes the conversion factor, RVUs, GPCIs, component dollars, and MPFS rate. The dialog shows any applicable Medicare Part B adjustment settings above the unit table.

Check facility reimbursement​

When a facility contract applies, open Facility reimbursement to review the contract, payment term, calculation details, and total facility reimbursement. Select the contract or payment-term link to open the relevant contract setup.

You should know​

Billing details and invoices can differ​

Billing details always shows the current data for its facility, patient, payor, and service date. A facility invoice derives source data from billing details when you create it, but it does not update automatically. The invoice can therefore differ from the current billing details.

For example, a facility invoice is created on Monday using the service items and minutes then available. On Thursday, a therapist adds a service item or changes the minutes on a treatment from Monday. Billing details then shows the updated items, units, and reimbursement calculation, while the existing invoice still shows the values captured when it was created.

No billing details are available​

If the dialog says no billing-details record is available, confirm that the day has billable service items and that the billing provider, service location, and clinician setup are complete.

Frequently asked questions​

How can I see billing details for a patient on a day they don't have treatment?​

Open an evaluation, re-evaluation, or treatment for that date, then select Billing details. RehabAlpha does not have a separate patient-day billing-details page, so you cannot open this dialog for a date that has no service document.

What to do next​

Use the linked source documents in Service items to review or correct the day's service items. Then review the current calculations against the related facility invoice when your billing workflow requires it.