Step | Description | Helpful Knowledge |
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Navigate to your Company Account and select Funders | | |
Click Add Funder to add a new funder to your account. Click View for an existing Funder, then click EDIT to set up the Billing and Scheduling Rules for that Funder | Image RemovedImage Added | |
Once you click EDIT or ADD FUNDER, choose the Funder Type from the drop down | | Insurance: Group Health Plans, Commercial Payers, Medicaid, Tricare Other: Schools, Regional Centers, etc. Private Pay: Self Pay
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Add a Vendor ID (if applicable) | | Vendor ID/Payor ID Please note, if you have signed up for the Rethink Self-Billing product, you are required to enter in the Vendor IDs for each funder. Specifically for our billing, you can find this information from the TriZetto Clearinghouse
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Type out the Funder Name | | |
Enter Funder Address | | |
Set the Billing Rules: These will be based on your funder contracts | | |
Select your Combine Rules based on your funder contracts | | These are not the combining of appointments. This is on the backend for billing purposes and will dictate how appointments are seen on the Billing Export Report pulled from the Reporting Dashboard Oftentimes Self/Private Pay will choose “Don’t combine charges” Some Funders want you to combine charges for the Same Day, Client, and Procedure & others want you to combine charges only if it is for the same Day, Client, Procedure, AND Rendering Provider
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Set Scheduling Rules: this allows you to decide if concurrent billing should occur or what type of warnings you will or will not receive when scheduling appointments | | Select Don’t Allow, Allow, or Warn & Allow to the first few Scheduling Rules based on your Funder Contracts Select the Checkbox if you want staff to be able to verify appointments on expired certification Option to restrict users from scheduling on specific dates
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Option to add Insurance Plans | | This area would allow you to keep track of the different plans within that funder such as if the funder had a Platinum or Silver plan option When you set up your clients you can then assign which insurance plan they have according to that funder If you have signed up for the Rethink Self-Billing product, your Self-Billing Implementation Specialist will train you on this area
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Select the Coverage Type (only applicable for insurance type funders) | | |
Select Service Facility (only applicable for insurance type funders) | | If you have more than one location available you would want to choose your main office location/the location your funders have on file for billing purposes Please note that the service location is pulled from the location assigned to the client in Rethink, this area is just for documentation purposes
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