Billing and Payments
Billing workflows, claims, payments and related configuration and rules.
By Bridget1 author27 articles
AttributesTo configure Attributes, navigate to: Configurations -> Billing -> Providers and Encounters -> Encounter Attributes
Attributes ...
Encounter → Service → Claim FlowHow Ritten turns clinical documentation into a submitted claim — the end-to-end billing flow.
Payer & Payer Group ConfigurationHow to configure payers and payer groups, including Stedi connectivity and Medicaid-as-secondary billing.
Fee SchedulesHow fee schedules work, payer-specific rates, modifier fallback behavior, and known limitations.
Three Service Generation MethodsThe three ways Ritten generates billable services: single encounter, encounter bundling, and autogen.
Ritten Billing Module UpgradeWe've reimagined our primary billing page to make Ritten Billing even easier and more powerful for our billing users.
Check out the vide...
Service Rules — Overrides, Additives & Advanced OptionsHow overrides and additives let you situationally change billing rule outputs without creating new rules.
Bundle vs. Batch vs. ConsolidateCritical distinction between Bundle, Batch, and Consolidate — three concepts that are frequently confused.
Manage Payer TypesSummary
Configure Payer types which are used for billing rules. Example: Aetna. This can help group payers to make it easier to bill the s...
Authorizations (Auths) & Utilization ReviewHow authorizations work, auth matching logic, propagation rules, no-show handling, and Utilization Review.
Service Rules — InputsInput fields define when a service rule fires — the gate that determines if an encounter matches.
Service Rules — OutputsOutput fields define what gets billed — CPT codes, units, modifiers, add-on codes, claim type, and more.
RCM Terminology GlossaryDefinitions for every term used in Ritten's RCM and billing module.
Utilization ReviewHow to use Utilization Review to track authorization usage, spot expiring auths, and identify overbilling.
Professional Claim (CMS-1500) Data SourcesField-by-field reference showing where Ritten populates each box on the CMS-1500 and whether it is required for clearinghouse submission.
Services & Billing CensusHow to work the Services screen and Billing Census for per-diem workflows, plus common service-layer issues.
Multi-facility billing
Background:
Many providers have several locations that bill under different facilities. Ritten can accommodate that structure through b...
VOBs / Eligibility ChecksHow to run eligibility checks, what VOB results mean, V2 improvements, and known limitations.
Claims — Types, Creation & ManagementClaim types, how to create them, splitting logic, attachments, and management rules.
Corrected, Void & Replacement ClaimsStep-by-step workflow for corrected claims, void claims, and replacement claims on both CMS-1500 and UB-04.
EDI Loop → Box Number ReferenceTranslation table mapping EDI loop references in rejection messages to human-readable CMS-1500 and UB-04 box numbers.
MN-Specific Rules & 42 CFR Part 2Minnesota-specific billing requirements: 42 CFR Part 2 NTE requirement, H2036 config, calendar month splits, and ERA edge cases.
Diagnosis CodesHow diagnosis codes work in Ritten — ICD-10 decimal handling, timing on claims, ICD-10 vs. DSM, and primary diagnosis defaults.