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Commure Pro clients use the Desktop Charge Capture and Mobile Charge Capture applications to enter charges and then perform error checking and validation of those charges. The clean charges are then either electronically interfaced to an external system for final billing (the most common scenario), or they are printed on batch reports for manual re-entry into another system for final billing. In prior versions of the Commure Pro application, the Billing Routers setting on the Admin tab, in conjunction with an outbound Billing Interface created by Commure Pro Integrations team, were used to transmit the charges to the external system. This method was able to successfully transmit the charges and indicate when those charges were submitted to the external system. However, it did not provide the client with any information about whether the charge submissions were successfully received by the external system. See Steps for Configuring a Billing Interface for more information. Starting with Commure Pro version 8.1.7.51, a new method of transmitting charges to an external system via Charge Routing was implemented. This method takes advantage of the routing capabilities of the CPOE application (modified for charges) and provides more information to the client about whether the charge transactions have been successfully received by the external system, via the Admin > Tracking/Reporting tab and the Charges > Charge Reconciliation tab. If your organization was implemented prior to the introduction of Charge Routing, you can continue to use the Billing Interface method; you are not required to switch to Charge Routing unless you want the additional reporting capabilities described above. If your organization wishes to implement the Charge Routing process, contact your Commure Pro representative for evaluation; a Statement of Work by the Integrations team will be necessary. See Steps for Configuring Charge Routing.

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Availability of the Charge Routing on Web versus Handheld Platforms

Charges entered on any platform (web, Android, or Apple) are routed to an external system based on the configuration defined by the client.

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Steps for Configuring a Billing Interface

Configuration of an outbound Billing Interface to an external system requires only a few steps by the client administrator, along with work by the Commure Pro Integrations team. The configuration steps are as follows:
Configuration StepWhere Documented
1. Define the Billing Areas for each department, including the method by which charges should be committed (manually or automatically) and sent to the Billing Router.Defining Billing Areas
2. Define the Billing Routers used by your organization and assign each department to use one of the defined Billing Routers.Defining Billing Routers

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Defining Billing Areas

Billing areas separate charges within a department for later review in the Holding Bin and also allow for the creation of separate batches of charges once they are committed from the Outbox to final billing. Billing areas created for one department are not available to other departments. Each billing area can belong only to one department at a time. Billing Areas can have parent-child relationships. In this way, you can group billing areas into categories and subcategories that you can use for billing and filtering purposes. In the following example, Cardiology is a parent billing area for the other three. You can filter by Cardiology, but you can’t bill to it. Instead, you must bill to one of the child categories.
NameParentBillableFilterable
CardiologyNoneNoYes
Cardio-CongenitalCardiologyYesYes
Cardio-PediatricCardiologyYesYes
Cardio-ThoracicCardiologyYesYes
To create or edit a Billing Area:
  1. Select Admin tab followed by the Department tab.
  2. Select a department from the list and then click the Edit button in the Quick Details box.
  3. Select Charge Capture from the Edit Settings drop-down list.
  4. In the Billing Areas field, select the [Edit] link.
  5. To create a new billing area, click the New Billing Area button (or select an existing Billing Area and click the Edit button in the Quick Details box).
  6. Specify the following properties for the billing area: ID This setting appears in the Create Billing Area form only if an ID is required, based on the following institution-level setting: Require ID for Billing Areas. Some inbound and outbound charge interfaces require an ID for each billing area in order for the charges to flow properly from one system to another. Name Give the billing area a name that uniquely identifies it. Abbreviated Name Give the billing area an abbreviated name to be used when displaying the billing area information in tables. Parent Billing Area If there are any parent billing areas defined, they will appear on the drop-down list. If you want this billing area to be a child billing area, choose the Parent for this billing area. Otherwise, leave this field unchanged. Aliases Enter any aliases that may be defined for this area in your source ADT registration system. When charges are created for this billing area, they can be integrated automatically. If you would like to map multiple billing office codes from your source system to one billing area in the Commure Pro system, enter the billing office codes in the Alias field separated by commas. For example, you could map the three billing codes: cardiopulmonary, cardiothoracic, and cardiacsurgery to the Cardiology billing area by entering them in the Alias field separated by commas: cardiopulmonary, cardiothoracic, cardiacsurgery. In addition, set the Initial Default Value and/or Subsequent Default Value for the Billing Area charge transaction header to Default from ADT, so that it uses these mapped values (see the section on Charge Transaction Headers in Charge Header Attributes). Billing Batch Schedule This setting determines when all charges within this billing area are committed and sent to final billing. The available options are:
    • Manual: Charges are committed and batched only when you manually commit charges in the Outbox by clicking the Commit button on the Charges > Outbox tab.
If you choose the Manual option, you can also determine whether the charges are grouped into individual batches by billing area, or are combined into one batch for the department, via the following setting:
Admin - Department - Charge Capture - Batch Charges by Billing Area or Department (manual commits only). - o Automatic: Specify a schedule for the system to automatically commit and batch the charges for this billing area. Once the charges are committed, they are either sent to the Billing Router (for a Billing Interface) or they are routed to a specific destination via Charge Routing, depending on which option your organization has implemented. A separate batch is created for this billing area, according to the schedule you choose below:
  • Immediately: Commits the charges for this billing area automatically after they are moved to the Outbox.
  • Daily: Choose a time of day when all charges in the Outbox (for this billing area) will be automatically committed.
This field automatically defaults the time zone for you. If the regular mobilizer and the billing mobilizer are both located in the same time zone, then only one choice is available and it is defaulted. In the rare case where the mobilizers are located in different time zones, then both choices are available, and the billing mobilizer’s time zone is defaulted. In this case, if the billing mobilizer’s time zone is earlier than the regular mobilizer’s time zone (i.e., it is located to the east of the regular mobilizer) then you may want to change the time zone to match the regular mobilizer’s time zone. This will prevent an issue where charges are sent to the Outbox during a specific time frame (for example, between 6 PM and 7 PM CST) but are not automatically committed on that day because the billing mobilizer is configured to commit at 7 PM EST (which is 6 PM CST).
  • Weekly: Choose a particular day of the week and time when all charges in the Outbox (for this billing area) will be automatically committed. (See NOTE above regarding time zone.)
If you choose the Automatic option, a change must also be made to the pkConfiguration.properties; please contact your Commure Pro representative to make this change.
Enable Holding Period This setting determines whether charges are held for a short period of time, so that all users, and more specifically providers, have an opportunity to make changes or corrections prior to the charges being Sent to Billing. For example, you might configure a billing area to automatically commit and batch charges every night at 11:00 pm. This means that if a provider entered a charge that had no errors today, it could potentially be sent to billing at 11:00 pm tonight. In this example the provider only has a short window of time to make changes. You can use this setting to prevent charges from being sent to billing until a minimum specified amount of time has passed, thereby giving users a window of opportunity for making corrections or changes to charges. For example, you could specify that at least 48 hours must pass before a charge is sent to billing. The period of time can be calculated from either the Charge Submission Date or from Service Date. Please note that even if a charge spends some portion of time as a Draft or in the Holding Bin, that time is still counted toward the holding period. For example, if the holding period were configured for 48 hours, and a charge spent 20 hours as a Draft before the provider saved it as a completed charge, and then it went to the Holding Bin and spent 4 hours there before being sent to the Outbox, then it would only be held an additional 24 hours in the Outbox before it became eligible to be sent to billing. Only charges that are actually in the Outbox are considered be in a billing hold period (in this example, the charge would be in a billing hold period for the last 24 hours). Please note that by enabling a holding period, you are not granting access to editing charges in the Outbox. If a charge is being held in the Outbox because a holding period is in effect for the billing area, then in order to edit that charge, a user must still have the setting below enabled in their user profile: Admin - User - Charge Capture - Allow User to Edit Charges in Outbox To enable a holding period for this billing area, configure the options below:
  • Number of Hours: Leave this field blank if you do not want to configure a holding period for this billing area. Or, if you do want to configure a holding period, enter the number of hours that it should last. After this number of hours have passed for a given charge, then:
  • If the charge is already in the Outbox, it becomes eligible to be sent to billing.
  • If the charge is not yet in the Outbox, then it becomes eligible to be sent to billing as soon as it is sent to the Outbox. If you have created an automated schedule for committing charges, then the charge will be sent to billing the next time the schedule is run. If you commit charges manually, then the charge will no longer be listed as a “held” charge on the Outbox tab.
  • Service Date: Select this option if you want the holding period to be based on the Service Date of the charge transaction. When this option is selected, the charge typically goes into a holding period immediately after it is saved, but the expiration of that holding period is calculated from 11:59 pm on the Service Date of the charge transaction. For example, if the Number of Hours is set to 48, then:
  • If a charge with a Service Date of 11/22 is entered on 11/22 at 4:00 pm, it immediately enters a billing hold period, and that hold period expires on 11/24 at 11:59 pm, which is 48 hours after 11/22 at 11:59 pm. The actual time elapsed from the time the charge was entered is 8 hours (from 11/22 at 4:00 pm to 11/22 at 11:59 pm) plus 48 hours.
  • If a charge with a Service Date of 11/21 is entered on 11/22 at 4:00 pm, it immediately enters a billing hold period, and that hold period expires on 11/23 at 11:59 pm. The actual time elapsed from the time the charge was entered is 30 hours (from 11/22 at 4:00 pm until 11/23 at 11:59 pm).
  • If a charge with a Service Date of 11/19 is entered on 11/22 at 4:00 pm, it never enters a billing hold period, since the expiration for the hold period (11/21 at 11:59 pm) will have already passed.
If the Service Date on a charge is edited, the holding period is recalculated from the new Service Date.
  • Charge Submission Date: Select this option if you want the holding period to start from the date and time that the user initially saved the charge transaction (even if it was initially saved as a Draft). For example, if the Number of Hours is set to 48, then:
  • If a charge is entered on 11/22 at 4:00 pm, it immediately enters a billing hold period, and that hold period expires on 11/24 at 4:00 pm, which is 48 hours after it was entered. The Service Date on the transaction is irrelevant. Filterable This setting determines whether the billing area is visible as a filter choice on charge reports (Holding Bin, Worklist, and Charges). If this setting specifies “no” for all billing areas belonging to a department, the department does not display among the list of departments available for the charge report areas.
Billable This setting determines whether or not users can post charges to this billing area. It is visible as a choice on the billing area drop-down list when posting charges. Active Status This setting tells you whether a billing area is currently Active or Inactive. Inactive billing areas do not appear as choices in the charge entry screen. However, when they display in the Holding Bin, Worklist, and Charge Search, these areas are identified by the prefix “I-” to indicate that they exist in inactive status. Allowed Commure Pro Visit Types This setting allows you to define the usage of this billing area to a limited set of Commure Pro Visit Types. For example, if the Cardiac Surgery billing area were only used in an inpatient setting at your organization, you might select the Inpatient visit type here. When you specify one or more visit types here, you then have the option of implementing either or both of the features below:
  • You can configure a short list for the Billing Area charge header that would show this billing area as an available value only when entering charges for the visit types that you selected here (in our example, it would show Cardiac Surgery as an available value only when entering charges for Inpatient visits). To do so, for the Billing Area charge header, set the Show Short List property to “Configured Restrictions.” If you want the Billing Area charge header’s short list to be restricted to only those billing areas that have the specified visit types, leave the Allow Access to Full List property unchecked.
  • You can configure the Billing Area charge header to default this billing area into the field when entering charges for the visit types that you selected here (in our example, to default Cardiac Surgery when entering charges for an Inpatient visit). To do so, for the Billing Area charge header, set the Initial Default Value and/or the Subsequent Default Value to “Default by Commure Pro Visit Type and Location.”
Both of the features above can be used in conjunction with the corresponding features for Allowed Locations. If you leave this field blank, then this billing area can be used for all Commure Pro Visit Types. Allowed Locations This setting allows you to define the usage of this billing area to a limited set of Locations. For example, if the Cardiac Surgery billing area were only used at East Hospital and West Hospital at your organization, you might select those two locations here. When you specify one or more locations here, you then have the option of implementing either or both of the features below:
  • You can configure a short list for the Billing Area charge header that would show this billing area as an available value only when entering charges for the locations that you selected here (in our example, it would show Cardiac Surgery as an available value only when entering charges for services rendered at East Hospital or West Hospital). To do so, for the Billing Area charge header, set the Show Short List property to “Configured Restrictions.” If you want the Billing Area charge header’s short list to be restricted to only those billing areas that have the specified locations, leave the Allow Access to Full List property unchecked.
  • You can configure the Billing Area charge header to default this billing area into the field when entering charges for the locations that you selected here (in our example, to default Cardiac Surgery when entering charges for services rendered at East Hospital or West Hospital). To do so, for the Billing Area charge header, set the Initial Default Value and/or the Subsequent Default Value to “Default by Commure Pro Visit Type and Location.”
Both of the features above can be used in conjunction with the corresponding features for Allowed Commure Pro Visit Types. If you leave this field blank, then this billing area can be used for all Locations.
  1. Click Save to save your selections, or Cancel to discard them.
  2. Click OK to confirm. You are returned to the Choose Billing Area form.

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Defining Billing Routers

Billing Routers determine where the charge information is sent after the charges have been committed from the Outbox, so that your organization can manage its billing. To create a Billing Interface or a specific format for a printed report, you will need assistance from the Commure Pro Integrations team; contact your representative for assistance in creating the appropriate Billing Routers for your organization.
Billing Routers are typically used as part of any Billing Interface that was configured prior to Commure Pro version 8.1.7.51, and can continue to be used in subsequent releases. Post 8.1.7.51, your organization can opt to use Charge Routing instead of a Billing Interface. See Configuring Charge Routing to External Systems for an overview of the difference between the two methods.
To add or edit a billing router:
  1. Select Admin tab followed by the Institution tab.
  2. Select Charge Capture from the Edit Settings drop-down list.
  3. In the Billing Routers field, click the [Edit] link.
  4. To create a new billing router, click the New Billing Router button (or select an existing Billing Router and click the Edit button in the Quick Details box).
  5. Complete the fields as follows: Label Enter a name for the billing router. Type This field has no effect, you may choose either Printer or File. Parameters Enter any settings associated with the router, such or specific criteria for a batch report or an interfaced file. You can work with the Commure Pro Integrations team to determine the necessary parameters and also whether the batched charges should be compiled in a report (which can be viewed or printed via Charges > Outbox > [select Billing Area] > Preview or Charges > Outbox > [select Department] > Batch History > View, Print, or Preview), or whether a file should be created for an interface to an external system, or both.
  6. Click Save.
  7. Click Return to Charge Capture Settings and then click Save again. Adding a new billing router only creates the billing router and does not mean that departments have been assigned to use it. You must now specify which billing router to use for each department, as described in the steps below.
  8. Select Admin tab followed by the Department tab.
  9. Select a department from the list and then click the Edit button in the Quick Details box.
  10. Select Charge Capture from the Edit Settings drop-down list.
  11. In the Billing Router field, select the type of billing router to use for this department.
  12. Click Save.
  13. Click Return to Choose Departments.
  14. Repeat Step 2 through Step 6 for each department in which your end-users will enter charges.

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Steps for Configuring Charge Routing

Charge Routing takes advantage of the routing functionality that is available in the CPOE application (specifically Destination Groups, Destinations, and Route Actions). This document provides a brief, summarized overview of that functionality, as applied specifically to the routing of charges. For an in-depth description of these features, please see Configuring Order Routing. In general, the steps for configuring charge routing occur in the sequence below. It is expected that a Commure Pro representative will work closely with you to define the criteria for items 2 through 6 below, and will then configure the appropriate settings for you (client administrators should not modify any of these settings).
Configuration StepWhere Documented
1. Configure the Billing Areas for each department, including the method by which charges should be committed (manually or automatically).Defining Billing Areas
For clients who have not previously used the Billing Interface method, the Billing Routers option (Admin > Institution > Charge Capture > Billing Routers) does not need to be configured. For clients who have previously used the Billing Interface method, and now wish to switch to Charge Routing, you may leave the Billing Routers option as it is currently configured. Although Charge Routing typically does not use this setting, the Integrations team will evaluate your current Billing Router configuration and determine whether there is a valid use for it when designing the new interface.
2. Define the Destination Groups for each of your facilities.Documented internally at Commure Pro
3. Define the Destinations for each of your facilities and associate each of your Destinations with a Destination Group.Documented internally at Commure Pro
4. Define the Route Actions for each of your facilitiesDocumented internally at Commure Pro
Administrative access to the settings for Destination Groups, Destinations, and Route Actions varies, depending on your system’s configuration. See Accessing Settings for Charge Routing Configuration for more information.
5. Define the list of users who should receive email alerts when the interface encounters errors.Documented internally at Commure Pro
6. Your Commure Pro representative must also make several changes to the pkConfigurations.properties file.Documented internally at Commure Pro
7. (Optional/Ongoing) Once Charge Routing has been implemented, you can monitor the progress of the outbound charge interface via the Tracking/Reporting tab or the Charge Reconciliation tab.Monitoring Charge Routing Activity
Once Charge Routing has been implemented, you can monitor the progress of the outbound charge interface via the Tracking/Reporting tab. See Monitoring Charge Routing Activity.

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Accessing Settings for Charge Routing Configuration

Access to some of the settings necessary to configure Charge Routing (specifically Destination Groups, Destinations, and Route Actions) varies, depending on which applications are implemented at your organization. In all cases, only Commure Pro staff should modify these settings when used for Charge Routing.
  • If Charge Capture and CPOE are both implemented, and CPOE Facility Groups are also enabled, then access to the routing settings is available to a Level 0-1 user via this option:Admin > Facility Group.
  • If Charge Capture and CPOE are both implemented, and CPOE Facility Groups are not enabled, then access to the routing settings is available to a Level 0-1 user via this option:Admin > CPOE.
  • If Charge Capture is implemented, but CPOE is not implemented, then access to the routing settings is available to a Level 0 user (typically Commure Pro staff) via this option:Admin > CPOE.

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Monitoring Charge Routing Activity

Once your system has been configured for Charge Routing, you can monitor how communication takes place between the Charge Capture application and the external billing system to which you are interfacing charges. Data that is exchanged between Charge Capture and the external system includes statistical data on the status of submissions and processing by the recipient system. In addition to communication-related data, the Commure Pro monitoring tools also provide some additional detail about the charges sent over the HL-7 interface, such as information about the user who entered the charge and the patient associated with each charge. Charge Routing activity can be monitored in two different options:
  • Via the Charge Reconciliation tab: This option is designed specifically for routine monitoring of HL7 interface activity for charges. It gives a high-level overview of charge interface activity. See Monitoring Charge Routing to an External System.
  • Via the Submission Status tab: This option is used to track many different types of submissions, but can be used to view specific Charge Routing interface activity. It gives both high-level and detailed information about charge interface activity. See Monitoring Charge Routing via the Submission Status Tab.

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Monitoring Charge Routing via the Submission Status Tab

The Submission Status tab is used to track many different types of submissions, but by configuring a few filters on the Search Criteria screen, you can filter the data to view only Charge Routing interface activity. Specifically, you can review the status of charges that are interfaced from Commure Pro to an external system. Similar, though less detailed information can be found on the Charges > Charge Reconciliation tab (see Monitoring Charge Routing to an External System). The following statistics enable you to track all data sent over the HL-7 interface, between Charge Capture and the external system:
  • The total number of charges submitted
  • The total number of invalid charges submissions
  • The total number of charges submission failures
  • The total number of valid charges, prior to and after external processing
  • The total number of charges queued for external processing
  • The total number of processing failures and successes
  • The average back-end and server processing times
  • The maximum back-end and server processing times To monitor all Charge Routing specific activity:
  1. Select Admin > Tracking/Reporting > Submission Status.
  2. From the Submission Status tab, click the Select Patient button and choose a patient if you plan to restrict monitoring data to a specific patient.
  3. In the Application field, select Charge Transaction.
  4. In the Submission Record Type field, select ChargeTransactionRoutingSubmissions.
    When you select ChargeTransactionRoutingSubmissions, a new criteria field for Batch ID is added to the screen. When charges are committed from the Outbox to final billing, whether done manually or automatically according to a schedule, they are placed in a batch with a Batch ID. You can use this criteria field to search for submissions from a specific batch. See Committing Charges to Final Billing and Viewing a Batch Report/Monitoring Batch Status for more information.
  5. (Optional) If your organization is configured for more than one interface to an external system, you can use the criteria fields below to restrict your search results to one interface or another:
    • Route Type
    • Destination Group
    • Destination
  6. (Optional) In addition, you can use any of the criteria fields below to refine your search even further. For more information about any of these search filters, see Filtering Submission Records.
    • Time frame or Start Date and End Date: These criteria fields use the submission creation date.
    • Status: The only statuses that apply to a outbound charge interface are listed below, in the order in which they occur:
      • Submitted: Indicates that the record has been submitted for processing. This is a transient state that lasts for only a few seconds.
      • Queued to Destination: Indicates that the submission record has been successfully parsed and is placed in the external processing queue.
      • In Processing: Indicates that the submission record is being processed by the external system. This is transient state that lasts for only a few seconds.
      • Processing Failure: Indicates that the submission has been submitted for processing in the external system the maximum number of times (as defined in your system configuration), and has failed each time. As a result, the interface will no longer attempt to reprocess the submission. This state can also occur if the external system does not accept the charge. For example, Commure Pro might send a submission to the external system, and that system might read it and reject it because the patient MRN did not exist in the external system. In this case, the external system responds indicating that the data was received, but that it was not processed.
      • Completed: Indicates that the submission record was processed successfully by the external system.
    • User: This is the authorizing user for the charge transaction.
    • Submission Id
    • Department
    • Location
    • Session ID
    • Batch ID: Each batch that is sent to final billing from the Outbox is assigned a batch name using the following format: departmentNAME_batch_nnnnn, where NAME is the name of the department, and nnnnn is a unique number (for example, departmentCARDIOLOGY_batch_12225). The numeric portion of the batch name is the Batch ID (12225 in our example).
    • Maximum # of Results
    • Include Ignored Records
  7. (Optional) Click the Refresh Summary button to view a summary, based on your selected criteria, at the bottom of the screen. The Summary displays the a variety of information, which is documented in Submission Status Reports.
  8. Click the Show Detailed Results button to view the status of all charges that were submitted over the HL-7 interface. The Search Results screen displays the following information:
    • Submitted column: The date and time when the charge was submitted over the HL-7 interface.
Click the link in this column to view more information about a specific charge. For more information, see Viewing Additional Information about a Submission Record.
  • Device column: (Not applicable to outbound charge interface records.)
  • Type column: For all outbound charge interface submissions, the type of submission is ChargeTransactionRoutingSubmission.
  • Status column: The status of the submission.
  • Patient column: The name of the patient associated with the charge.
  • User Name column: The username of the user who entered the charge.
  • Ignored column: This column is visible only if the current user has the Submission Record Management preference set to Yes, and if one or more records in the Search Results has a status of Processing Failure. If you have investigated the issue and do not want the submission to appear on the Search Results any longer, check the box in this column to indicate that the submission should be ignored. The submission is not included in future Search Results, unless the Include Ignored Records option is checked on the search criteria screen.
  • Submission ID column: This is the database’s primary key for the submission. Each row in the Search Results is a unique submission.Order Session ID column: For outbound charge interface submissions, this column contains the ID of the session in which the data was created (when the batch was committed).
    • Additional Info column: For outbound charge interface submissions, this column shows the Batch ID.
    • Failure Reason column: The reason why the submission record is held, or why the processing failed.
  1. Click the Back to Criteria button to return to the Submission Status screen. For more information about elements on the Submission Status tab, see Submission Status Reports.