How it works

Billing Cycle – FUND E-Z HIPAA Billing Version 10
  1. Enter your billing claims with one of the following options:
    • Add claims manually.
    • Import claims.
    • Add via a quick click-thru calendar interface.
    • Add using a batch process called filtered claim creation.
  2. Create and submit the HIPAA billing file.
  3. Download a 997 confirmation file.
    • 997 may confirm that the billing is good and accepted.
    • 997 may show that billing was rejected and show you the invalid claim, automatically setup your rebill claims and conveniently bypass the entire remittance process.
  4. Download an 835 electronic remittance advice.
    • FUND E-Z reads the remittance and creates cash receipts for paid items.
    • Writes off A/R open bills with paid items.
    • Adjusts open A/R bills with credit/debit memos for prior period adjustments.
    • Sets up rebills for deleted items and posts reasons for the denial  (Rebills can be fixed by the user prior to resubmission).
  5. Create new HIPAA billing file for new bills and rebills to begin the cycle again.
Claim Types and Statuses

FUND E-Z Claims undergo ‘type’ and ‘status’ changes as they flow through the billing cycle.  The following table depicts possible claim states as they flow back and forth through the HIPAA cycle:

Type Status
Original Unbilled
Original Submitted
Original Paid
Original Denied
Rebill Submitted
Rebill Denied
Rebill Paid
Void Unbilled
Void Submitted
Void Denied
Void Paid
Adjustment Unbilled
Adjustment Submitted
Adjustment Denied
Adjustment Paid

*FUND E-Z maintains a detailed claim history on every single claim that flows through FUND E-Z HIPAA billing.  In addition to the type and status field, the claim history will show details relating to the date, time, code and user that was involved in the creation, submission, denial, resubmission and payment of the claim.