> ## Documentation Index
> Fetch the complete documentation index at: https://docs.officeridge.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Billing

> EVV-matched claim generation, 837P export, remittance posting, and AR aging.

Billing covers EVV-matched claim generation, 837P export, remittance posting, and AR aging.

Claims here are generated from EVV-verified visits. Texas Medicaid requires a matching EVV
transaction, so a visit that never cleared verification cannot become a payable claim.

## Who can use it

Organization Admins and Finance Managers.

## The billing dashboard

Above the tabs, a summary shows where your revenue is sitting: what is ready to bill, what is
submitted, and what is aging.

## Claims

Payer claims generated from EVV-verified visits with submission and payment tracking.

**Columns:** Claim # · Member · Payer · Service · Units · Charge · Paid · Status · Submitted

Billing statuses are `NOT_BILLED`, `READY_FOR_BILLING`, `BILLED`, `PAID`, and `DENIED`. The gap
between **Charge** and **Paid** is what your AR aging is made of.

## What else lives here

<CardGroup cols={2}>
  <Card title="Claim lines" icon="list" href="/billing/claim-lines">
    The per-visit service lines behind each claim.
  </Card>

  <Card title="Remittances" icon="receipt" href="/billing/remittances">
    Payer 835 remittance advices posted against claims.
  </Card>

  <Card title="EVV matching" icon="link" href="/billing/evv-matching">
    Bill code configuration and match results.
  </Card>
</CardGroup>

## The billing chain

```mermaid theme={null}
graph LR
    A[EVV visit<br/>verified] --> B[EVV match<br/>bill code rule]
    B --> C[Claim line]
    C --> D[Claim]
    D --> E[837P export]
    E --> F[Remittance<br/>835 posting]
```

Each stage depends on the one before it. A claim that will not generate almost always traces back to
a visit that did not verify or an authorization that did not cover it.

## Generating and submitting claims

<Steps>
  <Step title="Clear EVV exceptions first">
    Unverified visits do not produce claim lines. See [Time & Attendance](/attendance).
  </Step>

  <Step title="Confirm bill code configuration">
    The service must have a matching EVV bill code rule. See
    [EVV matching](/billing/evv-matching).
  </Step>

  <Step title="Review generated claims">
    Check **Units** and **Charge** against the authorization before submitting.
  </Step>

  <Step title="Export the 837P">
    Submit to the payer. **Submitted** records the date.
  </Step>

  <Step title="Post remittances">
    As payments arrive, post the 835 against the claim. See
    [Remittances](/billing/remittances).
  </Step>
</Steps>

<Warning>
  Review before submitting rather than after. A claim submitted with the wrong service code or unit
  count has to be corrected and resubmitted, which restarts the payment clock.
</Warning>

## Working denials

A claim in `DENIED` status carries the payer's reason. Denials cluster into a few recurring causes:

| Cause                                         | Where to fix it                           |
| --------------------------------------------- | ----------------------------------------- |
| Authorization expired or out of units         | [Authorizations](/members/authorizations) |
| Service code does not match the authorization | [Authorizations](/members/authorizations) |
| Member identity mismatch                      | [Members](/members)                       |
| No matching EVV transaction                   | [Time & Attendance](/attendance)          |
| Bill code rule not configured                 | [EVV matching](/billing/evv-matching)     |

## Troubleshooting

| Problem                                     | What to check                                                                                               |
| ------------------------------------------- | ----------------------------------------------------------------------------------------------------------- |
| A visit happened but no claim generated     | The visit must be EVV-verified and covered by an active authorization with units remaining.                 |
| Units on the claim differ from the schedule | Claims use actual delivered units from the EVV visit, not planned units.                                    |
| Claims sit in NOT\_BILLED                   | They have not yet been picked up for submission. Check the bill code configuration applies.                 |
| Paid is less than Charge                    | The remittance carries adjustment codes explaining the difference. See [Remittances](/billing/remittances). |

## Related

<CardGroup cols={2}>
  <Card title="EVV to paid claim" icon="route" href="/guides/evv-to-claim">
    The whole chain, end to end.
  </Card>

  <Card title="Month-end billing close" icon="calendar-check" href="/guides/month-end-billing-close">
    A repeatable close routine.
  </Card>
</CardGroup>