- We have to submit AIHP claims (837) directly to the AHCCCS. Will we be able to submit the 837 file to the AHCCCS?
Yes, our clearing house supports AHCCS (Arizona Medicaid). We can support the following: Professional Claims, Institutional Claims, Eligibility, ERA’s, and Secondary Electronic Claims with this payer. We also support the downloading of the 837 files and we are currently confirming what the additional cost is for this.
- For Coordination of Benefit claims we will need to be able to print the 1500 form. We will be able to print 1500’s from KIPU?
1500 forms can be printed utilizing Kipu’s Integrated Billing platform.
- We will be able to report off of each 837P created and submitted?
Yes, Kipu’s Integrated Billing Platform allows for reporting of both created and submitted 837P claims.
- Are we able to view the 837P prior to submission?
Yes, Kipu’s Integrated Billing platform allows you to view, edit, and preview the 837P (what it would look like if you printed it) prior to submission via clearing house or batch printing.
- Does KIPU have built in “scrub” features – clean claim?
Yes, Kipu has built in “scrub” features that allow the system to automatically catch any missing or incorrect fields within the claim form prior to submission. These claims will show up in Status Control with a red alert (exclamation point) next to them that show an error is detected. Upon clicking the error the system will provide a detailed explanation of what fields are missing or incorrect. Please see below for additional information regarding the claim scrubbing capabilities.
NCCI Edits: Prevents improper payments of procedures that should not be billed together.
CPT/HCPCS Edits: Code Validation, Age Validation, Gender Validation, Add-On Code Edit, Relative Value Units sequencing.
ICD Code Validation: Date of Service, Specificity, Valid Primary Diagnosis, Duplicate Diagnosis.
Modifier Use: Date of Service, Global Fee Period, Invalid Modifier Use.
Medical Necessity: Proprietary Medical Necessity, Non-Primary Diagnosis should be primary.
Additionally, you have the ability to choose whether you want claims to be scrubbed automatically as they are entered, when changes are made, or only when a claim contains multiple charges.
- How many customized reports can we create?
Kipu’s Integrated Billing platform does not have a restriction on the amount of customized reports that you can create. Further, there is no charge for our team to work directly with you to assist in building your required reports.
- The database is SQL, correct?
Yes, the database is SQL based.
- Do they have any smart connect features?
The database can be connected to via the API or alternatively there is also a “Data Snapshot” functionality which essentially creates a duplicate of the database for your data needs. Please note that Kipu is already working with the database directly through our Business Intelligence platform. This provides for real time financial dashboards and analytics that can provide a live visual reporting environment that can provide many financial KPI’s that organizations want to be able to monitor.
- Will the 835’s auto import or will we have to download from Emdeon and import into KIPU?
Kipu’s Integrated Billing platform automatically imports 835 files (Electronic Remittance Advice). There is an ERA dashboard within the Payment section that allows you to show any 835’s that have been received. This can be queried for a specific date or an entire date range. You can then post payments for the ERA’s that have been received. There is no need to export/import 835 files from the clearing house and then into our billing platform. The payments also post automatically from the ERA’s that you receive.
- Emdeon has several features within its platform; can we have a list of the features that come with the current pricing?
Kipu’s Integrated Billing platform includes Real Time Claim Submission, Claim Status, Eligibility, ERA’s (Up to the included amount of 2,500), and access to the Change Healthcare portal which includes access to see recently submitted agreements and current status.
- If we are able to receive eligibility files from the Health Plans, is KIPU able to handle the import & data validation?
Kipu’s Integrated Billing platform allows you to view the eligibility of a patient without the need for a manual import or download. The data is displayed natively within the system.
- We will be able to submit 5,000 claims AND receive 5,000 835’s/ERA a month, correct?
Yes, we have offered to increase your Claims and ERA’s to 5,000 each for an additional $1,000 per month. Originally, we had offered up to 2,500 claims AND ERA’s.
- Are resubmits counted?
Yes, resubmitting claims would count towards your claims total.
- Instead of being charged $.25 for every claim we go over; can we go to a volume based fee scale? For example: 1– 500 over flat $50.00, 501 – 1000 $ flat, etc?
0.25 $ is Kipu’s actual cost for additional claims and ERA’s. We have offered to increase your claims total for an additional $1,000 per month. Beyond that, we are unable to offer volume based tiers as we are already offering you additional claims at our actual cost.
- Are we able to use KIPU to reconcile payments, billing, vs reporting/receivables, revenue?
Yes, Kipu’s Integrated Platform allows for the ability to have reports that can be used to reconcile payments, billing, AR/Receivables, and Revenue. You can also reconcile claims sent/created to insurance with Kipu’s Transmission Report via Batches.
- Are we able to create AR reports and billing reports – Adhoc?
Yes, Kipu’s Integrated Billing platform has a report builder which allows you to pick which columns of data you would like in a report. This also allows you to assign calculations to these columns (SUM, MAX, AVG, etc) so that you can have any column of data you have selected calculated. Additionally, you can specify what filters you would like to have available for that report. For example, claim entered date, practice ID, rendering provider, date submitted, date of service, CPT/Procedure code, diagnosis code, by payer, etc. There are many different filters you can pull into a report. The reporting is extremely flexible and our team is always available to work with you to build any reports that are needed. In fact, we have many AR reports already built into the reports section out of the box for our customers as we have built these reports for other customers.
- How long is the expected implementation process?
Our average implementation typically takes between 4 and 6 weeks from start to finish. Please note that our Integrated Billing team will be working together with your team to establish an implementation project plan which would include timelines to reach specific implementation objectives in a timely matter so that we can ensure we meet your suggested “Go-Live” date.
- Will they come on site? What does support look like after implementation?
Kipu is happy to come on-site for training and Kick-Off for the Integrated Billing implementation. Kipu has an unlimited support model so there is never any additional cost for requesting support whether it be web based, telephonically, or in-person.
- Is KIPU web based or we will be on a server?
Kipu is a completely web based platform. There is no requirement for any servers at your facility that you would have to manage.
- How is data stored? Is there an additional charge?
Kipu stores all data on the cloud which is hosted by Amazon Web Services. Please note that our Integrated Billing platform also has a document storage feature (attachments) which is rarely utilized. Most of our customers store documents/attachments w within our EHR which includes unlimited storage. The document storage portion of our Integrated Billing platform is rarely utilized, but has a fee of $55 per month per gigabyte in excess of the included 1 GB. Just to be clear – this is just for storing of attachments. The rest of the data stored within the billing platform and does not have a limit.
- Our accounting software and EHR are two separate systems. We need to be able to export data from the EHR to enter entries in QB; Are there any limitations on what information can be exported?
Our Integrated Billing platform’s report builder allows us to build a GL Reconciliation report that you could export to reconcile and import into your Quickbooks. All reports are exportable in CSV/Excel formats. This is something we address during the implementation with your team.
- How will it capture manual checks and paper EOB’s? Are we able to enter the check in KIPU and post against it?
Kipu’s Integrated Billing platform allows for the posting of cash, check, and credit card payments for patient payments. Additionally, if you receive a Check/EFT payment from a payer you can also post these payments against charges as you would like. This includes the ability to document the Check # and EFT# as part of the payment. Once you have indicated which payer has made the payment you can then post these payments to the charges they are related to. Further, you can actually have the system bring up a list of charges/claims that have not been paid by the “Sent Date”. This makes it super easy to bring up exactly the list of claims you are looking to post payments to rather going through an entire list of claims that are pending payment by that specific payer.