The BillingBuilder feature in the AWARDS Fiscal module enables users to bill payers for services provided to clients and recorded in AWARDS. Payers can include Medicaid, Medicare, private insurance, self-paying clients, or any other third-party payer that accepts the 837I or 837P electronic billing file, HCFA paper claim forms, or printed invoices.
Required Permissions
Use of the BillingBuilder requires the following permissions:
- Display BillingBuilder Button
- Display Executive Administration Buttons OR Display Fiscal Buttons (only required if you are not a member of the "Fiscal Staff" or "Executive Officer" user groups)
Understanding BillingBuilder Functionality
You can learn more about BillingBuilder functionality by clicking the links below:
- Billing Setup - Learn to use the setup components of the BillingBuilder to prepare it for processing claims.
- Billing Processing - Learn to use the processing components of the BillingBuilder to process claims.
- A/R Management - Learn to complete various Accounts Receivable data entry tasks.
- Billing Reports - Learn to view available billing reports.
Other Helpful Resources
Training Films & Demonstrations
- COVID/Telehealth Modifications - Configuring AWARDS Billing to Add Telehealth Procedures (1 hr 50 min) - March 18th, 2020
- COVID/Telehealth Modifications - Emergency Billing for PROS in AWARDS (59 min) - April 22nd, 2020
- iKnow - BillingBuilder (1 hr 36 min) - September 2017
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New Features & Functions - Change Health Clearinghouse and Portal Demonstration (51 min) - March 2018
- A walk through our Change Healthcare Clearinghouse service. This add-on service provides a wide variety of benefits to BillingBuilder agencies, including direct transmission of 837 claim files from AWARDS to Change Healthcare, and direct receipt of 835 remittance files from Change Healthcare into AWARDS, thereby removing the need to store these types of files on a user's device. In addition, implementation of this service streamlines an agency's claim submission and adjudication process, resulting in faster claim responses, and also provides access to the powerful data tracking and reporting capabilities found in the Change Healthcare Portal.
- A walk through our Change Healthcare Clearinghouse service. This add-on service provides a wide variety of benefits to BillingBuilder agencies, including direct transmission of 837 claim files from AWARDS to Change Healthcare, and direct receipt of 835 remittance files from Change Healthcare into AWARDS, thereby removing the need to store these types of files on a user's device. In addition, implementation of this service streamlines an agency's claim submission and adjudication process, resulting in faster claim responses, and also provides access to the powerful data tracking and reporting capabilities found in the Change Healthcare Portal.
- User's Conference Continued - Cleaner, Faster, More Secure Claims Processing (60 min) - June 2018
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User's Conference Continued - Exploring the 837 Claim File (1 hr 10 min) - July 2019
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Do you want to better understand how AWARDS populates 837 claim files? Of course you do! This video explores the complex relationship between AWARDS data and the various 837 data segments. (Click here for exclusive content referenced during this recording.)
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Do you want to better understand how AWARDS populates 837 claim files? Of course you do! This video explores the complex relationship between AWARDS data and the various 837 data segments. (Click here for exclusive content referenced during this recording.)
Related Documents
Instruction Sheets, Tip Sheets, and Quick Reference Guides
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BillingBuilder - Managed Care (MCO) Setup for Hard-Coded Billing - Quick Reference Guide
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BillingBuilder - Telehealth BillingBuilder Configuration - Instruction Sheet
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NY OMH Residential Rehab Services Rate Code Updates - Information Sheet (May 2023)
PROS Resources
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BillingBuilder - Emergency PROS Billing Guide - Information Sheet (NY PROS Programs) - Will be updated soon!
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PROS Documentation in AWARDS - Instruction Sheet - Will be updated soon!
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PROS Program Setup - Instruction Sheet - Will be updated soon!
HIPAA Reference Docs
- HIPAA 270/271 Medicaid Eligibility Request Files - Instruction Sheet
- 837I Loops and Segments Guide
- Common Codes Suggestions for HCPS, UB92, and CMS Code Values
- New Jersey Medicaid Companion Guide Reference
- Original 270/271 Health Care Eligibility Benefit Inquiry and Response Implementation Guide
- Original 835 Health Care Claim Payment/Advice Implementation Guide
- Original 837 Health Care Claim Institutional Implementation Guide
- Original 837 Health Care Claim Professional Implementation Guide
- Original 997 Functional Acknowledgement Guide