WEBVTT 00:00:05.210 --> 00:00:12.300 Hi there. Irina here, and welcome to another Xander video. Today, let us talk about Xander's integration with Medicare 00:00:12.310 --> 00:00:20.920 and DVA Australia. Uh, and this integration helps you to streamline the entire claiming and payment process for your practice. 00:00:20.930 --> 00:00:28.130 Instead of manually submitting and tracking claims via your Proda account, this integration allows you to manage everything directly 00:00:28.160 --> 00:00:36.280 within your Xander account. We provide this integration to simplify your administrative tasks, speed up your payments, and provide a 00:00:36.340 --> 00:00:39.320 clear digital record of every claim. 00:00:39.740 --> 00:00:45.970 So in this video, let's talk about the Medicare and DVA payment status report. It's a critical part of 00:00:46.000 --> 00:00:52.520 this integration. It is the final piece of the puzzle that closes the loop on each bulk bill and DVA 00:00:52.560 --> 00:01:00.100 claim, giving you a detailed breakdown of its journey from submission to payment. This, this report is not just a 00:01:00.160 --> 00:01:08.840 summary. It's a powerful tool that helps you understand payment outcomes, identify and resolve any issues, and ensure your billing 00:01:08.900 --> 00:01:18.240 is accurate and efficient. Think of a payment status report as a detailed receipt from Medicare and DVA. 00:01:18.280 --> 00:01:25.460 It fetches Medicare feedback to you to explain exactly what happened, if the bulk bill or DVA claim was paid, 00:01:25.520 --> 00:01:31.800 how much was paid, or if there. was a problem that needs your attention. Knowing how to read these reports 00:01:31.860 --> 00:01:38.180 is es- essential for making sure your practice gets paid correctly and on time. So in this video, 00:01:38.200 --> 00:01:43.420 I will walk you through how to request, access, and interpret these reports 00:01:43.780 --> 00:01:46.000 for Medicare bulk bill and DVA 00:01:46.060 --> 00:01:51.160 claims so you can easily understand what Medicare is telling you. 00:01:58.560 --> 00:02:01.020 Let's now talk about how to request 00:02:01.340 --> 00:02:09.720 the payment processing report from Medicare. And we are now here, on the Tools, Medicare dashboard. Before we proceed requesting 00:02:09.758 --> 00:02:16.160 the report, let me show you one optional, but very important setting. So if we scroll down 00:02:16.220 --> 00:02:23.609 to the bottom of the settings page, we can see here the bulk bill and DVA claims, uh, section. Uh, 00:02:23.640 --> 00:02:28.600 and what we highly recommend you is to set up this automatic payment allocation 00:02:28.960 --> 00:02:34.980 functionality for your Medicare integration. What this means is, uh, when you, uh, submit 00:02:35.100 --> 00:02:43.880 the claims and request the payment report from Medicare, uh, and you, uh, y- your Xander account receives information back 00:02:43.940 --> 00:02:48.520 from Medicare about those claims, this will allow the system to automatically 00:02:48.940 --> 00:02:57.380 allocate payments to invoices, uh, once the claims are returned as paid in your payments report. So this refers 00:02:57.440 --> 00:03:03.500 to bulk bill and DVA claims, and this is how you can enable them. You just click, uh, you will 00:03:03.660 --> 00:03:10.000 b- see, see the hyperlink here. They are activated for my account now. For your account, they can be disabled. 00:03:10.020 --> 00:03:16.269 But anyway, you'll see the word disabled, which is hyperlinked. Click on that link, and you will see the settings 00:03:16.380 --> 00:03:20.120 page here. And all you need to do is to turn on 00:03:20.180 --> 00:03:27.140 this switch and select the payment method from your Xander account which you want to be used 00:03:27.540 --> 00:03:28.200 automatically 00:03:28.540 --> 00:03:34.100 to allocate that payment. So I have created manual payment method called Bulk Bill for my bulk 00:03:34.160 --> 00:03:41.240 bill claims and called DVA for my DVA claims. You can, uh, set up those custom payment methods 00:03:41.640 --> 00:03:44.060 however they work best for your process 00:03:44.640 --> 00:03:54.260 and then save those changes. Wonderful. So let's go back to our, um, Medicare dashboard. 00:03:54.280 --> 00:03:57.040 We have enabled the automatic allocation of bulk bill 00:03:57.080 --> 00:04:05.049 and DVA payments, so we don't need, uh, to worry about those anymore, and we can start looking at how 00:04:05.140 --> 00:04:13.320 to request the payment status report from Medicare. Uh, so for that, we will use these filters available at the 00:04:13.360 --> 00:04:17.890 top. And you can narrow down the list of claims you want to, um, 00:04:18.120 --> 00:04:20.260 request the payment report 00:04:20.579 --> 00:04:20.839 for 00:04:21.420 --> 00:04:27.120 based on, uh, the claim provider, location, the claim date, or the 00:04:27.420 --> 00:04:29.040 timeframe between, 00:04:29.060 --> 00:04:29.800 uh, um, 00:04:30.200 --> 00:04:39.040 when the claims have been submitted. Uh, as it takes up to 48 hours for Medicare to process the claims 00:04:39.060 --> 00:04:46.790 and to pay out bulk bill and DVA, um, payments that have been, uh, for the successful claims, I highly 00:04:46.900 --> 00:04:47.960 recommend you that you 00:04:48.060 --> 00:04:49.160 wait for two 00:04:49.240 --> 00:04:56.240 days, uh, before you, uh, submit the payment processing report for your claims. So for example, you've been submitting 00:04:56.260 --> 00:04:58.100 the claims, uh, um, the whole week, 00:04:58.620 --> 00:05:04.000 and then you can go and check and request this report the next Monday. So that weekend, 00:05:04.040 --> 00:05:06.320 for example, will give you that 48 hours 00:05:06.820 --> 00:05:14.020 buffer, and you will be able to retrieve the payment reports, receive them from Medicare. Use the 00:05:14.120 --> 00:05:16.960 claim status and claim type 00:05:17.180 --> 00:05:23.920 filters to narrow down the list of claims, and then, uh, let's use the approved only and 00:05:24.000 --> 00:05:31.720 click search, and the system will generate the list of claims for you that, um, correspond to those filters you 00:05:31.920 --> 00:05:38.040 set up. Now that we have the list of claims generated for us, we will be able to submit 00:05:38.600 --> 00:05:40.480 the, uh, request 00:05:40.980 --> 00:05:47.420 for the payment status report. If you've done this before for these claims, you will see that this button 00:05:47.430 --> 00:05:55.080 will be grayed out, so you won't be, uh, duplicate the request for the payment status report for the same 00:05:55.140 --> 00:05:58.140 claim. But let's say we've sent that, Medicare 00:05:58.180 --> 00:06:02.060 received our request, and it will take a little bit of time 00:06:02.680 --> 00:06:03.560 to process 00:06:03.720 --> 00:06:13.128 and send the information back to us.Once Medicare service response has been received for these claims, the information about them 00:06:13.208 --> 00:06:14.068 will populate 00:06:14.168 --> 00:06:20.968 here in these last two columns on Medicare dashboard, uh, the paid and the run number. So, what 00:06:21.008 --> 00:06:27.788 we are interested in is the information that has been populated into these two columns. Let's have a look. So, 00:06:27.848 --> 00:06:30.048 if it says, "Not available", it means the report 00:06:30.448 --> 00:06:38.128 isn- isn't available yet, so it's too early for Medicare to have processed this report, or it could be too 00:06:38.168 --> 00:06:45.628 late, um, because this report is only available for six months, um, uh, after the claim has been submitted. 00:06:45.668 --> 00:06:46.118 If it's, 00:06:46.228 --> 00:06:51.988 uh, has the status "Not run", it means there has been some problem with this claim, so you 00:06:52.028 --> 00:06:55.028 might want to take a look into this, and I will show you a little 00:06:55.068 --> 00:07:03.668 bit later how this can be done. Uh, and then if you see, uh, the amount here in the paid 00:07:03.788 --> 00:07:06.028 column, this is how much has 00:07:06.088 --> 00:07:06.868 been paid, 00:07:07.488 --> 00:07:10.308 um, for this claim by Medicare. 00:07:10.328 --> 00:07:13.128 And these four digits in the last column, 00:07:13.167 --> 00:07:15.328 like 0520 00:07:15.448 --> 00:07:23.228 here, this is the run number, so this is the, uh, code that Medicare allocates to the 00:07:23.288 --> 00:07:28.948 payment it has paid for the claim. If you check your bank feed, you will see that 00:07:29.028 --> 00:07:31.228 the payment that has come through from Medicare 00:07:31.588 --> 00:07:33.248 will have the same four digits 00:07:33.668 --> 00:07:40.058 as an identifier for this, um, payment, for this claim, so you can easily match your records. So, 00:07:40.108 --> 00:07:43.168 this is the run number that Medicare sends back 00:07:43.208 --> 00:07:46.608 with the payment reports. 00:07:47.228 --> 00:07:52.088 Another helpful button here for us is the View Payment Status report. 00:07:52.448 --> 00:07:57.148 So, when we click it, we will see the, uh, breakdown and the list of the claims 00:07:57.208 --> 00:08:00.048 that have been paid, um, im- in 00:08:00.408 --> 00:08:01.408 this payment 00:08:01.748 --> 00:08:06.988 report that you have requested. So, let me show you what it looks like. So, when we 00:08:07.028 --> 00:08:11.928 click it, this is what we will see. Uh, so we will see that this is about bill and DVA 00:08:12.008 --> 00:08:18.148 payment report. It will show us the claims that have been sent from a specific timeframe. So again, 00:08:18.188 --> 00:08:24.128 you can use these, um, date filters to narrow down and find the pla- uh, claims that have 00:08:24.148 --> 00:08:31.228 been paid within that timeframe. Uh, and this is what you can see here, uh, with a bit of information 00:08:31.288 --> 00:08:36.688 about each claim. Let us have a look quickly at all the fields that are available here for you that 00:08:36.768 --> 00:08:43.977 already provide you some information. So, the claim sent, this is the date, uh, when you have submitted the claim. 00:08:44.008 --> 00:08:49.968 The patient is obviously the client who received the services under this claim. This is the invoice number. This is 00:08:50.028 --> 00:08:55.968 your Zenda invoice number that is linked to this claim. This is the claim ID that have been generated by 00:08:56.048 --> 00:09:02.268 integration, and it will be the same ID in your Zenda account and in, um, uh, y- a- a- a- 00:09:02.268 --> 00:09:08.288 and in Medicare that you can use this as an identifier, for example, if you call Medicare about a claim 00:09:08.328 --> 00:09:16.188 to find out something. The servicing provider number, this is your practitioner who provided this service. This is the practitioner's 00:09:16.288 --> 00:09:25.448 provider number. The charge amount, this is the amount owing on the invoice that you submitted, um, uh, as a 00:09:25.488 --> 00:09:34.408 claim to Medicare. The paid amount, this is the amount that Medicare paid back, paid you, uh, under this claim. 00:09:34.418 --> 00:09:42.698 The run number information, again, if you see the four-code digit, uh, four-digit code, sorry, this is the informa- um, 00:09:42.728 --> 00:09:45.378 this is the payment run number 00:09:45.768 --> 00:09:52.128 you can see in your bank feed, and, um, this is what Medicare assigns to the payment. 00:09:52.138 --> 00:09:58.788 And the date paid, this shows it, uh, if the claim was paid and when. And the payment assigned, if 00:09:58.888 --> 00:10:03.168 you enabled the automatic payment allocation and the payment has been assigned 00:10:03.568 --> 00:10:07.008 to your Zenda invoice through that feature, you will see 00:10:07.028 --> 00:10:13.018 this box checked. So now, let us have a look at some of these claims and see, 00:10:13.028 --> 00:10:17.348 um, what information we can r- um, get from those reports 00:10:17.768 --> 00:10:19.968 that, uh, come back to us from Medicare 00:10:20.048 --> 00:10:26.828 about why this claim has been paid or not paid and so on. Uh, so let us have a look 00:10:26.968 --> 00:10:34.208 first at this claim here at the top to find out why it was not paid. To do that, 00:10:34.288 --> 00:10:38.008 you just, uh, click the claim ID. I recommend 00:10:38.048 --> 00:10:39.028 that you use the 00:10:39.127 --> 00:10:41.127 o- um, the right-click 00:10:41.308 --> 00:10:44.127 option to open this link in the new tab 00:10:44.508 --> 00:10:50.098 so that you st- still have easy access to your payment report, but then you can check each, um, 00:10:50.648 --> 00:10:55.028 claim in a separate window. So, let's do that. 00:10:56.668 --> 00:11:03.138 Okay. So, we opened this, um, processing report first for this claim. 00:11:03.188 --> 00:11:06.148 We can see that although Medicare service response 00:11:06.228 --> 00:11:13.148 h- says the task has been completed successfully, it means that the claim has been received, the response has been 00:11:13.158 --> 00:11:16.048 received. Now let us have a look at what actually 00:11:16.108 --> 00:11:17.928 happened and why the paym- 00:11:18.048 --> 00:11:24.908 um, the payment wasn't, um, made. So, to do that, again, let's click the Processing Report button 00:11:25.028 --> 00:11:31.008 to open it in the new tab. And here, you will see here in the yellow, 00:11:31.108 --> 00:11:35.288 um, header, the information that Medicare sends you 00:11:35.308 --> 00:11:35.888 telling you 00:11:36.488 --> 00:11:44.008 what has happened to this claim, if there has been any issues with that. Uh, and so for example, it 00:11:44.028 --> 00:11:52.508 says that patient Medicare number has changed, please update the patient's data, this is their current, uh, Medicare number. And 00:11:52.568 --> 00:12:01.720 now-Further, you can see the claim processing summary, with all the information about this claim. Uh, the, uh, processing information, 00:12:01.740 --> 00:12:06.110 and also what is of, uh, high interest for us is the bottom information 00:12:06.220 --> 00:12:15.079 here in the service processing information. The service benefit amount is zero, and this is the explanation code. 00:12:15.120 --> 00:12:19.020 So, this is the code that Medicare sends back to you to explain 00:12:19.079 --> 00:12:21.000 what happened to this, 00:12:21.100 --> 00:12:26.939 um, claim. And the meaning of this code or the explanation text is that the quoted Medicare 00:12:27.000 --> 00:12:29.020 card number is incorrect. 00:12:29.500 --> 00:12:36.130 So, what you need to do, you need to go to this client profile, update their Medicare card information, and 00:12:36.439 --> 00:12:39.339 resubmit this claim to get paid. 00:12:41.020 --> 00:12:46.980 So, back here on our batch payment report, let's have a look at one of the successful, uh, claims 00:12:47.100 --> 00:12:49.380 and see, uh, what those reports 00:12:49.439 --> 00:12:53.470 might look like. Let's open this one, for example. 00:12:54.319 --> 00:12:57.960 And what we see here, again, the same claim, um, summary, and 00:12:58.060 --> 00:13:06.480 we can check the processing report for its information. And there you go, we can see the claim, uh, benefit 00:13:06.640 --> 00:13:14.760 paid. Uh, the explanation code here in the processing information. We can see that, um, some items have been claimed 00:13:14.939 --> 00:13:22.020 with the explanation of this payment, uh, but there have been other items on the same, um, invoice, on 00:13:22.060 --> 00:13:28.319 the same claim, that haven't been paid. And again, the, uh, explanation is provided. So really, this is the audit 00:13:28.380 --> 00:13:36.839 of your claim. It explains everything that has happened to it, and if anything needs your special attention. Uh, what 00:13:36.920 --> 00:13:41.500 happens if we check this payment report? Let's take a look. 00:13:42.439 --> 00:13:52.280 This payment report is sort of your, um, bank statement. It shows you all the information about, uh, this, uh, 00:13:52.319 --> 00:13:58.839 claim payment, gives you the payment summary here at the top. But it also lists all the other claims, 00:13:58.860 --> 00:14:00.360 and the benefit paid 00:14:00.780 --> 00:14:01.100 within 00:14:01.160 --> 00:14:08.980 the same run number. So, on the same date, these many claims have been processed by Medicare based on your, 00:14:09.079 --> 00:14:12.120 uh, provider details, and all these benefits have 00:14:12.140 --> 00:14:17.960 been paid into your bank account. So, the payment report, again, is your sort of bank statement, and you 00:14:18.000 --> 00:14:18.900 can use it to 00:14:19.000 --> 00:14:24.000 check with, uh, your actual bank statement to match all that information 00:14:24.120 --> 00:14:25.460 and reconcile. 00:14:27.060 --> 00:14:27.200 To 00:14:27.260 --> 00:14:34.860 finish today's tutorial, let me show you how you can quickly check the claim, uh, for just one particular invoice 00:14:34.930 --> 00:14:42.200 without going to Medicare dashboard. What you need to do is actually to find that invoice in your Zenda account. 00:14:42.210 --> 00:14:47.920 You can do this through the appointment panel if you see the appointment on your calendar, or you can just 00:14:48.140 --> 00:14:50.120 use the quick search 00:14:51.160 --> 00:14:57.160 feature here. And for example, if you know the, uh, invoice number or invoice client or the invoice date, 00:14:57.280 --> 00:14:58.960 use that information to 00:14:59.000 --> 00:15:06.660 look up that invoice. Uh, and you need to open the invoice edit page. Here, let's click Medicare and DVA 00:15:06.740 --> 00:15:12.400 button at the top, uh, and you will see if, uh, a claim has ever been submitted 00:15:12.780 --> 00:15:18.260 for this invoice. The information will be here. Uh, and, uh, if you need to learn more information 00:15:18.319 --> 00:15:24.000 to see, uh, or request those reports from Medicare, you just need to click the claim ID, 00:15:25.220 --> 00:15:29.160 uh, to open that, um, page. If the report has been, 00:15:29.260 --> 00:15:33.099 uh, previously sent, again, manually from this, um, 00:15:33.599 --> 00:15:41.160 single invoice page or from the Medicare dashboard, you will see the Medicare service response here. And if you want 00:15:41.240 --> 00:15:48.060 to get a bit more information about that report, please click this button, see if there is any information of 00:15:48.200 --> 00:15:55.120 interest for you. If the claim has been paid, if there's any explanation for this code. If, for any reason, 00:15:55.140 --> 00:16:02.020 the report is not available, you can use the repeat request processing report button. It will be available 00:16:02.079 --> 00:16:09.140 for each claim, so that you have the option to request that report again. 00:16:11.740 --> 00:16:17.040 That's all for today. I hope you found this video. useful, and that you will enjoy using your 00:16:17.079 --> 00:16:26.420 Zenda and Medicare integration even more. I will see you another time.