We understand the importance of efficient processing of claims for hospice operations. Consolo provides all the necessary components to make this process seamless, streamlined and secure in the core product:

  • Pre-Billing Verification Reports. Prior to processing claims, it is recommended that hospices run a series of reports to verify all data is complete and accurate. These pre-billing reports will help to reduce claim errors, returns, and denials.
  • CMS Change Request 8358 Compliant. Consolo has developed three methods to obtain the Medication Fill Data from pharmacies and add it to Claims, to meet the specifications defined by CMS in Change Request 8358.
  • Electronic Claims Generation. Allows the user to generate claims by any date range, office, payer or patient. Also provides the option to generate discharge claims only, increasing mid-month cash flow.
  • Hospice Clinical Visits. Consolo pulls all required clinical visits to Medicare claims. These visits are entered in the patient’s clinical charts by the staff and then flow to the Medicare claim automatically when it is generated.
  • Adjustment and Cancellation Claims. When a claim is sent to the payer and then a change is made to the clinical data in Consolo, an automatic adjustment or cancellation claim is created to alert the billing staff about this change.
  • Physician Services. Hospices can submit additional charges for physician services when appropriate. These are entered in Consolo and will automatically flow to the claims as an additional charge. Consolo provides a Physician Charge report to track the payment of these charges by date of service, physician, patient or even type of service provided.
  • Back Balance Claims. Allows the entry and tracking of external AR balances
  • Notice of Election Tracking. Consolo provides a screen to easily track the Notice of Elections that are unsent, complete with the number of days left before they are beyond the CMS timely filing deadline. It also tracks sent NOEs and the date they were sent to easily identify any that were sent late so that the first claim can be coded properly.
  • Electronic Remittance Advice (ERA’s). Consolo provides automatic or manual uploading of Medicare Electronic Remittances Advices. These ERAs can then be auto-posted by Consolo, greatly reducing the time involved in posting payments by hand.
  • Payments. Payments may be manually posted for all Payers at the line level or claim level. Adjustment Reasons and Adjustment Groups may be selected along with Write-Off Reasons.
  • Month-End Close. Months may be Hard Closed for accounting purposes.

Revenue Cycle Management Revenue Cycle Management is available from Consolo for Hospices that want to concentrate on patient care.

Additional Modules:

Direct Medicare Eligibility Verification – The Consolo Eligibility Verification Module is a Web-based verification tool that gives Hospice providers access to the Medicare eligibility system from within the Consolo application. The eligibility result is displayed and any information for that patient that does not match what is already in Consolo will be highlighted for correction. With the strict Face-to-Face requirements, this allows the hospice staff to verify eligibility in the field and obtain quick results. The data is also compiled into a Dashboard format, providing several tabs for analysis of data. The Eligibility Dashboard identifies whether or not patients have a successful eligibility result, have other insurance, have prior hospice, and many other pertinent categories. It also indicates the date that the eligibility result was run to help identify how fresh the data is. A separate Eligibility Report highlights changes over time and displays the most recent eligibility information on each patient who was active in a given date range.

DDE Access – The Consolo Direct Data Entry (DDE) module provides the Hospices a means for filing required Notice of Elections for patients and access to Medicare claims and eligibility data.  The terminal allows efficient access to the CMS data and may be used to view claims statuses for other provider types such as Home Health as long as the IDs are linked to each provider. This is an access point for the CMS DDE system. To obtain full access, a user would need to be issued a DDE user ID and password from their Medicare Administrative Contractor (MAC).

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