Page Description

Use the Billing Status Rules page to define the billing relationship between the business entity using Copia and the laboratories performing the testing for that business entity. In most cases, this is used for defining the billing status and billing account number that are sent to reference labs via Copia interfaces. Copia considers this to be "internal billing," while the billing status/account number settings for users, locations, and practices is "external billing." See the Setting Billing Account Numbers topic.

When Copia is assigning an internal billing status (see the Internal Billing Status topic), the hierarchy is: (from first to last)

• The status for an ordering location exception to the testing host for an insurance plan.
• The status for the testing host for an insurance plan.
• The status for an ordering location exception to the insurance plan.
• The status for an insurance plan.
• The status for an ordering location exception to the testing host for an insurance company.
• The status for the testing host for an insurance company.
• The status for an ordering location exception to the insurance company.
• The status for an insurance company.
• The status for an ordering location exception to the testing host.
• The status for the testing host.

For more help, click one of the following links:

• Accessing this Page
• Viewing the Rule List
• Adding or Editing Rule Details
• Adding or Editing Order Choice Exceptions

Accessing this Page

• Click the Administration menu button, click the Rules button, and then click the Billing Status Rules submenu link. You must have the necessary security permissions to access the Administration menu button.

When you click the Administration menu button, Copia opens the main Administration menu, which contains administrative menu buttons, including the Rules menu. To return to the main menu for Copia, click the Lab Tasks menu button.

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1. The Rule List section contains a list of up to ten billing status rules created to assign billing status and account numbers that are sent to reference labs via Copia interfaces. If the list is longer than one page, use the Page links, located below the list of routing rules, to navigate through the list.
2. To view active billing status rules only, select the Show active only checkbox at the top of the Billing Status Rules page. You set the inactive/active status in the Rule Details section of the Billing Status Rules details page. See "Adding or Editing Rule Details" below.
3. If you cannot find the desired billing status rule, click the Add button to add a billing status rule using the Billing Status Rules details page. See "Adding or Editing Rule Details" below.
4. Click the name of a billing status rule on the Billing Status Rules list page to view or edit rule information on the Rule details page. See "Adding or Editing Rule Details" below.

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Adding or Editing Rule Details

1. Use the Rule Details section of the Billing Status Rules details page to add or edit billing status rule information.
2. Enter a name for the billing status rule in the Rule Name field. This field is required.
3. To edit the rule name, highlight or delete text already displayed in the field, then modify as desired.
4. Select the Active checkbox to allow administrative users to select the billing status rule while creating or editing host or insurance company and plan information. Clear this checkbox to restrict administrative users from using the billing status rule. See the Admin: Hosts or Admin: Insurance topics. If the billing status rule is inactive, Copia will clear it from the Billing Status Rules list page when you select the Show active only checkbox. See "Viewing the Rule List" above.
5. Select an option from the Default billing status drop-down list to establish the billing status (Direct, Client, Patient, or No Status) Copia will use by default when this billing status rule is used.
6. When this rule is used, Copia will assign the default billing status you select to all of the order choices in the order, unless you have defined specific exceptions for one or more order choices. See "Adding or Editing Order Choice Exceptions" below.
7. Click < Back to List to return to the Billing Status Rules list page without saving any changes.
8. Click Save to record changes and return to the Billing Status Rules list page.

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Adding or Editing Order Choice Exceptions

1. Use the Order Choice Exceptions section of the Billing Status Rules details page to create billing status exceptions based on the order choice.
2. Enter one or more characters in the order choices search field, and then click the Search button to select an order choice using the Order Choice Search page. See the Order Choice Search topic. Repeat this search for each order choice that requires an exception. Note that you only need to add order choices that require a billing status exception.
3. Once you select one or more order choices, Copia displays the order choices with corresponding drop-down lists for the order choice's Status.
4. To add an order choice exception, select an option (Direct, Client, No Status) to set the billing status exception for the order choice.
5. When determining what billing status to assign, Copia uses the order choice's Status, if it is set up as an exception; otherwise, it uses the default billing status from the Rule Details section. See "Adding or Editing Rule Details" above.
6. Click < Back to List to return to the Billing Status Rules list page without saving any changes.
7. Click Save to record changes and return to the Billing Status Rules list page.

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