When You’ll Use This Article
Use this article when you need to:
Prepare for month-end closeout
Verify Medicare B and Managed B billing accuracy
Resolve charges outside of certification periods
Request billing exports or download Service Log Matrices
Role Applicability
DORs: Primary responsibility for month-end readiness and closeout
Therapists: Complete documentation and billing as requested
Billing Teams: Review exports and charge accuracy
Month-End Readiness Checklist
1. Enter Prior Medicare B Charges (Critical for KX Compliance)
For Medicare B and Managed B patients, prior charges must be entered to ensure accurate cap tracking and KX modifier compliance.
Who this applies to
New client organizations onboarded within the current calendar year
Patients who were Medicare B before onboarding to RESTORE-Insights
How to review
Go to Billing → Med B Cap Management
Filter by payer or patient
Review the Prior Charges column
Dashes indicate prior charges have not been entered
Workflow
Pull prior Medicare B charges from PCC
Enter the prior charges for each applicable patient
Confirm totals update correctly in the report
2. Review Charges Outside of Certification
Charges outside of certification periods must be resolved before closeout.
How to find them
Navigate to Billing
Use the Charges Outside of Certification report (bottom of the Billing tab)
This report shows:
Daily notes
Charges that fall outside an active certification period
3. Confirm Discharge & Billing Alignment
In RESTORE-Insights, the discharge date is the last treatment day.
Important rules:
All billing must be completed before initiating a discharge
If billing occurs after discharge, alerts will persist
How to resolve issues
Adjust the discharge date to match the last treatment day
ORSubmit a support request to:
Move the document to the correct Episode of Care
Delete the document if it is not needed
Key Reports & Tools
Service Log Matrix (SLM)
Available anytime under Reports Download
Used for internal review and reconciliation
Billing Exports
Billing exports are available upon request.
How to request
Open the purple Intercom chat
Select Request Billing Export
Complete the required fields
Your export file will be delivered once processed.
Important Notes
Prior Medicare B charges directly impact compliance reporting
Charges outside certification will appear in closeout alerts
Discharge timing affects billing eligibility and reporting
Using automated Intercom ticket types results in the fastest resolution
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If you need any further support, please contact your Customer Success representative. We’re always here to help!