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Managing Billing in NikoHealth

Overview of Billing Tabs and Managing Billing

Updated this week


INVOICE

The invoice tab will show you ALL of the invoice currently available in your system. It will show all status' (New, Hold, Submitted, Open, Close, Cancelled). You can filter down what you wish to see by using the search fields at the top OR by using the advanced filter (dark blue circle with 3 lines). From the blue plus sign on this sub-tab you can choose to:

  • Create a New Invoice

  • Add a Payment

  • Print patient statements

  • Import ERA's

  • Do a mass write off and close out claims

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PAYMENTS

The payments tab will show ALL of your payments collected in the system and their corresponding status (NEW, Unapplied, Applied, Failed, Completed). From here you can mange all of your payments that are processed manually or auto-posted by the system. From the blue plus sign you can :

  • Create a New Invoice

  • Add a payment

  • Jump to patient statements

  • Import ERA's

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REFUNDS

From a specific order or from the refund section located in the billing queue you can create and manage your returns, and refund payments to your customers. Here you can create the refund and restock the items if needed. You can refund an entire order or only part of an order. You can also refund an order without restocking the item.

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DENIALS

The Denials queue will allow you to work all of your Denials by Denial Reason or Payer using the filter options at the top. You will have the following statuses assigned to your denials:

  • New: a new denial that needs to be worked

  • Resubmitted: a claim has been resubmitted to be reviewed

  • Paid: a corrected claim comes back paid

  • Ignore/Write Off: you will not be working the denial

In the Denial queue, you can also CLAIM a denial to work by checking the box and then using the blue plus sign to mark something "In Progress". This will show the user who is working the Denial and assign the date they began working it.

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EOB/ERA

All of the ERA's that come into the system will come to this tab first and try to connect to the correct payer and payer ID before dropping to the Payment queue to auto-apply to the appropriate claim. Any ERA's that are in a failed status must be manually connect to the correct payer.

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PRESCRIPTIONS

Select the Prescriptions tab to see all Prescriptions that have been entered into NikoHealth. This will help you identify expired prescriptions. Use the advanced filters and search by upcoming prescriptions that are due to expire so you can work them ahead of their expiration date.

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AUTHORIZATIONS

Select the Authorizations tab to see all Authorizations that have been entered into NikoHealth. This will help you identify expired Authorizations. Use the advanced filters and search by upcoming authorizations that are due to expire so you can work them ahead of their expiration date.

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CMNS

This is your CMN expiration report. You can filter this by using the advanced filter and search by upcoming CMNs that are due to expire so you can work them ahead of their expiration date.

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