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Review and approve charges

Charges are captured automatically while you document. Charge review is where a reviewer checks each charge — code, units, modifiers and diagnoses — and approves it for billing or voids it.

Where charges come from​

  • Signed notes: when a provider signs an admission (H&P), progress, consult or discharge note, CollabKare proposes the evaluation and management (E/M) code from the note's Billing section, using the 2023 AMA rules: the level supported by medical decision making (2 of 3 of problems, data and risk) or by total time, whichever is higher. Admission 99221–99223, subsequent 99231–99233, consult 99252–99255, discharge 99238 or 99239.
  • Procedures: a signed procedure note with a CPT code.
  • Bill a visit / My Coder: charges entered by hand go to review too — they are never billable on entry.
  • Diagnoses are taken from the note's Assessment & Plan, in that order.

Charges from a resident's or APP's note show Awaiting cosign until the attending cosigns; residents' charges then get the GC modifier.

Before you start​

You need a reviewer role: Program Administrator, Clinical Director or Physician Advisor. Other roles can see the queue but not change it. Open Billing & Claims in the left navigation and choose Charge review.

Steps​

  1. Use the filters: In review, Approved, Billed, Voided, All.
  2. For each charge in review, check the CPT code, units, modifiers and the ordered diagnoses.
  3. If something is wrong, click Correct, fix it and save.
  4. Click Approve to make the charge billable, or Void with a reason if it should not be billed.

Separation of duties and solo practices​

  • You cannot approve a charge for a service you rendered — another reviewer must approve it.
  • A solo practice has no second reviewer. An administrator can turn on Self-approval (solo practice) in the Charge Master's Billing settings (Cloud Manager → Charge Master, or kareMD → Billing & Claims → Hospital bills → Setup). Each self-approved charge is marked and recorded in the audit trail.

Tips / Troubleshooting​

  • "Charge cannot be approved yet" lists what is missing — usually a valid CPT code, an ICD-10-CM diagnosis, or the attending's cosign.
  • Facility charges (room days, operating theatre time, consumables) do not come through review; they post directly to the hospital bill. See Issue a hospital bill.