Continue using the Billing module, now known as Billing (Archive) for service dates up to May 22nd, 2025. You can resubmit or review claims up to May 22, 2025, in the old invoice-based module, Billing (Archive).
Billing data for Friday, May 23rd , 2025, and forward, will be handled in the new batch-based module. Use this crosswalk to help navigate the new functionality available to you.
To learn more about the new Billing module, see our step-by-step guides in EVV Billing Product Help.
Attached is the Billing Module crosswalk document, which is the content that follows on this page. It is designed to help you make the transition to the new user interface for Billing.
New Billing Dashboard
The Billing Dashboard provides a quick view of your account information across tiles.
Use the From and To fields to limit the data to a specific date range.
Use the tiles to guide you with your billing tasks. For example, you may want to start with Unbilled Visits or Rejected Claims.
Each tile provides the following billing information:
- Total visits: displays the total number of visits that have occurred. These are all the visits in visit maintenance.
- Total claims: displays the number of total claims submitted, and the dollar value of those claims.
- Total Claim Responses: displays the number of total claims that have responses.
Visits with Billing Exceptions: shows the total number of visits with billing exceptions. Exception details are shown in the visit details screen of the billing module. - Unbilled Visits: displays the total number of unbilled visits.
- Rejected Claims: displays the number and dollar value of claims that have been rejected. The Payer has rejected the claim (see these in the batch view).
- Overdue Claims: displays the total number of overdue claims, along with the dollar value of the overdue claims. Visits that are billable but have yet to be submitted.
- Reports: takes you to a screen to run the Visits and Claims reports.
Upload X12 File Button: Select to open your file explorer and upload an X12 file. When you upload this file, the system will parse it and create a claim status transaction that pays the claim. The system will tell you how much of the claim is paid and create an invoice.
Using the new Sandata EVV Billing Module
In the navigation menu, when you select Billing, you’ll see the new menu items, starting with Dashboard. Billing is now based on processing visits into batches, where creating batches uses the same general process as creating invoices.
Current Billing Module: Billing (Archive) New Billing Module
Create Invoices is now Visits
To begin billing, you will create a new invoice which is now called creating a new batch. This is found in the Visits module.
1. Start by selecting Billing > Visits.
2. This opens the Visits page. Here you can select the date range for the visits to bill.
3. Next, use the Sync button to display the most up to date visit information.
4. The visits for the selected dates will load. Only those visits showing as Verified in Visit Maintenance will be displayed.
You can further narrow your search by using these search fields. Again, you will need to select SYNC.
| From, To | Last Name | First Name | Status | Billing Exceptions | Payer | Member ID |
5. To view visit details, use the eye icon. This opens the Visit Details page in the Billing module.
In addition to all the visit information, the Visit Details page includes the billable amount, the service lines, and any billing exceptions.
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Note: Notice that the URL is different from the other Sandata EVV URLS. This is important to have when working with customer support. Here is an example: https://fhir.uat.us-east-1.sandata.com/billing/#/visits/2159574090 |
6. Use the back arrow to return to the Visits screen.
7. Next, use the checkboxes to select the visits you want to include in the batch. Selecting the checkbox next to Client Name will select all visits.
8. Once all visits are selected, choose Save Batch.
You will now be directed to the Batches screen.
Submitting a New Batch (Formerly Submit Invoices and Submitted)
- Start by selecting Billing > Batches. This replaces the previous version of submitting Invoices. Follow the process below to submit claims.
The Batches screen displays the batches that you have created. Notice the navigation menu at the top of the screen.
2. Select the batch you wish to submit.
3. Inside this batch, locate and select the Claims tab.
4. Under the Claims tab, review the claims in the list. Use the following filters to help sort the claim information and status. Notice the number in parentheses (*). This refers to the number of claims related to that tab.
In this table, each claim status is defined.
| All | view all claims that are in the batch |
| Draft without exceptions | claims in draft form not yet submitted |
| Draft with exceptions | claims with billing exceptions in draft form not yet submitted |
| Sent | claims that have been sent for payment |
| Errored | claims that have been previously submitted, but need to be revised before resubmitting |
| To review | claims that need to be reviewed before re-submitting; there is an action that needs to be taken |
| Processed | claims that have been submitted for payment: the clearinghouse has received the claim. |
| Balanced | Claims that were paid |
| Payment-in-progress | Claims submitted awaiting payment we have received a message back from the clearinghouse that the payer has received the claim. |
5. Select Draft without exceptions and select each visit that is to be billed in this batch. If all, choose the top checkbox to select all.
To send, select Confirm & Send to send the claims ready for payment.
Adding Visits
Before you send, if you need to add a visit to a batch, select the visits tab, and select Add Visits.
This will take you back to the visits page, where you can select the visit(s) to add to the batch by selecting the checkbox next to Client name and then select Save Batch. Use the filters to find the visits you want to add.
9. Back inside of the Batch, revisit the Claims tab. Choose the top checkbox to select all, then select Refresh Draft Claims to see the new batch total. Do not skip this step!
If no other adjustments need to be made, select Confirm & Send.
Transactions
The batch is now listed as a set of claims under the Transactions tab. Here you can view the status of the claims.
Billing Reports
There are new reports in the billing module, which you will not find in the EVV Reports module. These are basically exports of your filtered data. You will access these reports via the Billing Dashboard.
Once selected, you have access to view the Claims report and Visits report. Use the eye icon to view.
Once inside of the report screen, use the search fields to narrow the reporting data.
Click on the Export button to export the report to an Excel file.
Viewing Claims Responses
To view Claim Responses, go to the Billing Dashboard and select the number on the Total Claim Responses tile.
This takes you to the Claim Responses page where you can use multiple filters to sort the claim responses. Some column headings are sortable.
Select the eye icon to view the Claim Response page.
The top half of a Claim Response page gives you basic information about the claim you have selected.
Use the dropdown arrow to view more details.
Resubmitting Claims
There will be claims that are returned or errored that you will need to submit.
Inside the claim you can view the error that needs to be resolved. In the example below, the claim needs the billing exceptions (update authorization) resolved before being resubmitted.
Find Claims that need to be resubmitted:
1. Locate the claim in the claims tab which can be found inside of a batch.
2. Use the filter to sort for claims in To-Review status.
3. Find and select the claim you wish to process again. Once selected, the resubmit button will appear. Select Resubmit.
4. The resubmit window will open. All fields are optional.
Fields:
Status dropdown options: select the correct status for this re-submission
- Original: the Payer did not receive the claim draft
- Replacement: change was made to claim draft
- Void: there was an issue with the claim amount, or the Payer has requested a different recoupment amount
Resubmission reason: enter the reason you are re-processing this claim.
ICN/PCN Selection: select this checkbox to use the original claim’s ICN number in the resubmitted X12 message. The ICN is the claim number in the payer system (you can find it in the payer portal). Use this if the payer already has the claim in their system.
Payer Claim Number (ICN): enter a new ICN number here if you have not received a response from the payer.
5. Select Yes to resubmit the claim.
Billing Exceptions
Here are a few examples of billing exceptions that need to be resolved. Resolve the exception in the Client profile, under the Program tab.
| Billing Exceptions | Description |
| Client Date of Birth | There is no Date of Birth on the Client profile. Update the Client profile in Visit Maintenance. |
| No authorization match | The authorization information in the Client profile needs to be added or updated. |
| Missing Diagnosis code | The diagnosis code in the Client profile needs to be added. |
Attached is the Billing Module crosswalk, to help you make the transition to the new user interface for Billing.
To learn more about the new Billing module, see our step-by-step guides in EVV Billing Product Help.
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