Encounter Review and Approval

Encounter Review and Approval Procedure:

Resilience will receive or create encounter (superbills) forms from clients that are in or are entered into Kareo a Resilience Technician. For billing purposes, the encounter/superbill contains all of the needed data to submit a claim or bill a patient.

A technician will need to review each encounter. After reviewing the encounters the technician will correct any errors and will approve the encounter turning it into a claim. This procedure will be completed at least two times per week, Tuesday and Friday.

During the review process the technician will:

• Review any account “Alerts” and apply any applicable notes to the encounter, such as self pay rates.
• Review the encounter for Insurance or self pay case information.
• Review provider, location and coding information for accuracy.
• Review the encounter for for any other errors or potential errors.
• Utilize the code check feature.
• Approve the encounter.

This procedure is the first step in ensuring accurate clean claims are created and subsequently submitted to payers.