Page Comparison

Go to Settings

Select Funder from the menu at the top

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

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

  • Please note for Private Pay, you may have to enter some fake information to fulfill the requirements. You will also choose your scheduling rules based on what you want to allow

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 ClearinghouseUsed for California customers to appear on the Parent Verification Form and BHPN Invoices

Type out the Funder Name

Enter Funder Address

• Phone, Email, and Fax are optional

Set the Billing Rules: These will be based on your funder contracts

• Select the checkbox if you want to convert session times to military times on your billing export

• Select the check box if you want to require the referring provider be entered on client authorizations and show up in your billing export

• Select the check box if you want the appointment time on the claim line in your billing export

  • The verified appointment time will be listed on the billing export regardless. If your Funders request it to be specifically in the claim line, select this

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

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

  • Warn & Allow will give you a soft warning when trying to schedule but will still allow you to save that appointment

• 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

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

Select the Coverage Type (only applicable for insurance type funders)

• Most commercial plans will be classified under “group health plan”

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