EZClaim Interface Setup

This setup is used for interfacing to either EZClaim Advanced or EZClaim Premier.

The export for EZClaim Advanced accesses the EZClaim database directly to export patients and claims while the export to EZClaim Premier creates an export file that will be read by the EZClaim Premier program. Please also refer to this document for additional required configuration steps in EzClaim Premier to be able to import files.

Don't forget to specify EzClaim as one of the External Billing Packages under Agency Office → Settings → Billing Settings. After changing this setting is it recommended that you close-and-reopen HomeTrak Companion.

HomeTrak must be able to export the Billing to a folder on your computer or the network that EZClaim will be able to access.

Field

Description

Path

For EZClaim Advanced: Identify the path to the EZClaim Database file.

For EZClaim Premier: Specify the path to a folder in which to create the export files that will be imported by EZClaim Premier.

Show total on Last Page

Check the box to Show Total on Last Page. Select this option to see a total on the last page of the claim in EZClaim.

No Diagnosis Code on Call Type, use all from Patient Record

(Applies to EZClaim Advanced only.)

If checked, when the diagnosis code is not specified on the Call Type (Service) below, exported line items on the claim will reference each of the client/patient's diagnosis codes listed on their claim information.

If not checked, when the diagnosis code is not specified on the Call Type (Service) below, exported line items on the claim will just reference the first diagnosis code listed in the claim information.

Grouping

Choose how billing records will be grouped on the exported claim.

Break Every Day	All records for the same Service (Call Type) that occur on the same day will be combined into a single line item on the claim.
Group Consecutive	All records for the same Service (Call Type) that occur on consecutive days will be combined into a single line item on the claim. Any day without a schedule will cause a break in the grouping and begin a new line item for the next series of consecutive days.
Break on Weekending	All records for the same Service (Call Type) that occur within a week will be combined into a single line item on the claim for that week.
No Grouping	No grouping will be done and all billing records in the export will be exporting as separate line items on the claim.
Group All	All records in the export for the same Server (Call Type) will be combined into a single line item on the claim.

Ignore Rate While Grouping

By default, when grouping (summarizing) claim lines for EzClaim, lines will be grouped on matching CallType and billing Rate. When enabled, the rate will be ignored, and only the CallType will be considered.

Call Types

Identify the Call Types and their necessary EZClaim interface information. This setup only needs to be completed once; however if you add new Call Types into HomeTrak Companion you will need to ensure that you add the appropriate information for any new Call Types on this screen.
Use the add, edit and delete options in this area of the screen to populate the appropriate information for your Companion Call Types.
Click the Add icon in the EzClaim CallType Setup portion of the screen to select the Call Type from the list of available call types; then enter the appropriate EZClaim information in the remainder of the fields.

Call Type	Select the Call Type from the list of available call types.
Place	The place of service for the particular call type. This field should be populated with the appropriate EZClaim Place of Service code. Example: Place of Service in EZClaim: 11 Office, 12 Home, 21 Inpatient Hospital, 22 Outpatient Hospital, 23 Emergency Room Hospital, 24 Ambulatory Surgical Center, 34 Hospice
Diagnosis Code	A specific ICD-9/10 diagnostic code that corresponds to the particular call type. Populating this field is optional.
Procedure Code	The procedure code used in medical billing. Each code represents a service performed and must be entered for the particular call type. Example: 99201 is the Procedure/CPT Code for New Patient Office Visit.
Modifier	The Modifier for the Procedure Code (if applicable). To handle multiple modifier codes (EZClaim Premier), enter each code in this field separated by a space or semi-colon character.
Hour Ratio	Select the number of units per hour that should appear in the claim for the particular call type. Identifies the number of units per hour the system should use when it converts hours to billing units in the claim. Example: If Units Per Hour is 4, then 1 hour will show as 4 units; each unit would be 15 minutes in length.