1. The Life of a Charge Epic
Lucas Moreira, Epic Research Analyst
Buck Rogers, Epic Research Analyst

2. Life of a Charge Epic Compliance – Billing Review
Epic Overview of Charge
Research Charge Route Scenarios
Billing Review Report
Refresher Trainings

3. Compliance – Bill Review
Life of a Charge Epic
Compliance – Bill Review

4. Compliance Implications:
Why:
1.) All Bills are held for research patients!
2.) Double-Billing –occurs when the same service is paid for by two different sources. HUGE FINE!
3.) Patients enrolled in Medicare FFS, Medicare Advantage plans, and Medicaid (Special Billing Rules Apply)
Example: Billing Modifiers – Q1 & Diagnosis code of Z00.6
When:
1.) Twice a week, minimum
2.) Patient accounts billed 4-5 days after discharge/encounter closed

5. Epic Overview of a Charge
Life of a Charge Epic
Epic Overview of a Charge

6. Step-by-Step view of a Charge in Epic, lab example
Lab order is placed
Lab gets resulted
Charge generates and drops onto patient’s HAR
Visit is closed, charge posts and HAR can be billed
HAR gets billed
Statement is generated
Claim goes out to payor
Remittance, charge is paid for

7. Research Charge Route Scenario
Life of a Charge Epic
Research Charge Route Scenario

8. -Add a patient to a timeline in Pt Rsh Studies

9. Three ways to route charges to research:
Automatically through the timeline/calendar
Linking the order to the study
Manually re-routing in bill review

10. 1. Automatically through the timeline/calendar

11. SPARC Calendar– It’s the Budget…

12. … in Epic, it looks like this (at the study level)...

13. … and like this when applied to a patient.

14. If you link the timeline to an encounter, charges from that encounter will route in accordance with your calendar

15. 2. Linking the order to the study

16. No encounter link, but can link the order

17. If no timeline, linking the order will route the charge to the research study

18. 3. Neither timeline or order linked, manual reroute in bill review

19. Life of a Charge Epic
Reporting Workbench

20. This report’s results only include those patients that still require coordinator review. Make it easy, make it a habit!!

22. Research Correction

23. Life of a Charge Epic
Refresher Training

24. Locate all Research Refresher Training Links on your Research Dashboard

25. Questions? epicresearch@musc.edu
Life of a Charge Epic
Questions?